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Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes

Background: Stroke-associated pneumonia (SAP) is associated with adverse clinical outcomes which increase the cost of hospitalisation. There are various factors that contribute to SAP among acute ischaemic stroke patients. However, data on SAP in our population are scarce. Hence, a study to deter...

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Main Author: Rahman, Sharifah Nursamihah Syed Abd
Format: Thesis
Language:English
Published: 2021
Subjects:
R Medicine
RC648-665 Diseases of the endocrine glands. Clinical endocrinology
RC705-779 Diseases of the respiratory system
Online Access:http://eprints.usm.my/60670/1/SHARIFAH%20NURSAMIHAH-E.pdf
http://eprints.usm.my/60670/
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spelling my.usm.eprints.60670 http://eprints.usm.my/60670/ Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes Rahman, Sharifah Nursamihah Syed Abd R Medicine RC648-665 Diseases of the endocrine glands. Clinical endocrinology RC705-779 Diseases of the respiratory system Background: Stroke-associated pneumonia (SAP) is associated with adverse clinical outcomes which increase the cost of hospitalisation. There are various factors that contribute to SAP among acute ischaemic stroke patients. However, data on SAP in our population are scarce. Hence, a study to determine the proportion and associated factors of SAP and its clinical outcomes is conducted and it is hoped that the findings of this study could guide future management of patient. Method: A cross-sectional study among acute ischaemic stroke patients who were admitted to Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan between January 2016 until December 2020, were studied. Systematic sampling method were used to select the patient. Variables collected were demograhics, comorbidities, clinical presentations, treatment of SAP and clinical outcomes. These variables were then analysed using descriptive, simple and multiple logistic regression for any significant associations. Results: 446 subjects with acute ischaemic stroke were selected in this study. Proportion of SAP is 22.9% (n=102). Significant independent associated factors for SAP are coronary artery disease (CAD) (OR 2.27, 95% CI (1.12,4.68), p = 0.024), high random blood glucose on admission (OR 1.152, 95% CI (1.081,1.23), p<0.001), nasogastric tube feeding (OR 4.04, 95% CI (1.91,8.56), p<0.001) and high A2DS2 score (OR 1.58, 95% CI (1.35,1.85), p<0.001). For the clinical outcomes, SAP has significant association with all outcomes that were studied; organ impairments (e.g. septic shock, acute kidney injury (AKI), liver dysfunction, respiratory failure, tracheal intubation, need of trachesotomy), recurrent hospital acquired infection (HAP), prolonged hospital stays, higher Modified Rankin Scale (MRS) score on discharge and inpatient mortality, p< 0.05. Conclusion: The significant independent associated factors for developing SAP are CAD, high random blood glucose on admission, nasogastric tube feeding and high A2DS2 score. SAP is significantly associated with adverse outcomes which are organ impairments, recurrent HAP, prolonged hospital stays, poor MRS score on discharge and inpatient mortality. Thus, preventive measure of these significant associated factors needs to be done to reduce incidence of SAP. 2021 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/60670/1/SHARIFAH%20NURSAMIHAH-E.pdf Rahman, Sharifah Nursamihah Syed Abd (2021) Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes. Masters thesis, Universiti Sains Malaysia.
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic R Medicine
RC648-665 Diseases of the endocrine glands. Clinical endocrinology
RC705-779 Diseases of the respiratory system
spellingShingle R Medicine
RC648-665 Diseases of the endocrine glands. Clinical endocrinology
RC705-779 Diseases of the respiratory system
Rahman, Sharifah Nursamihah Syed Abd
Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes
description Background: Stroke-associated pneumonia (SAP) is associated with adverse clinical outcomes which increase the cost of hospitalisation. There are various factors that contribute to SAP among acute ischaemic stroke patients. However, data on SAP in our population are scarce. Hence, a study to determine the proportion and associated factors of SAP and its clinical outcomes is conducted and it is hoped that the findings of this study could guide future management of patient. Method: A cross-sectional study among acute ischaemic stroke patients who were admitted to Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan between January 2016 until December 2020, were studied. Systematic sampling method were used to select the patient. Variables collected were demograhics, comorbidities, clinical presentations, treatment of SAP and clinical outcomes. These variables were then analysed using descriptive, simple and multiple logistic regression for any significant associations. Results: 446 subjects with acute ischaemic stroke were selected in this study. Proportion of SAP is 22.9% (n=102). Significant independent associated factors for SAP are coronary artery disease (CAD) (OR 2.27, 95% CI (1.12,4.68), p = 0.024), high random blood glucose on admission (OR 1.152, 95% CI (1.081,1.23), p<0.001), nasogastric tube feeding (OR 4.04, 95% CI (1.91,8.56), p<0.001) and high A2DS2 score (OR 1.58, 95% CI (1.35,1.85), p<0.001). For the clinical outcomes, SAP has significant association with all outcomes that were studied; organ impairments (e.g. septic shock, acute kidney injury (AKI), liver dysfunction, respiratory failure, tracheal intubation, need of trachesotomy), recurrent hospital acquired infection (HAP), prolonged hospital stays, higher Modified Rankin Scale (MRS) score on discharge and inpatient mortality, p< 0.05. Conclusion: The significant independent associated factors for developing SAP are CAD, high random blood glucose on admission, nasogastric tube feeding and high A2DS2 score. SAP is significantly associated with adverse outcomes which are organ impairments, recurrent HAP, prolonged hospital stays, poor MRS score on discharge and inpatient mortality. Thus, preventive measure of these significant associated factors needs to be done to reduce incidence of SAP.
format Thesis
author Rahman, Sharifah Nursamihah Syed Abd
author_facet Rahman, Sharifah Nursamihah Syed Abd
author_sort Rahman, Sharifah Nursamihah Syed Abd
title Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes
title_short Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes
title_full Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes
title_fullStr Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes
title_full_unstemmed Stroke associated pneumonia (SAP) among acute ischaemic stroke patients in Hospital Universiti Sains Malaysia : associated factors and clinical outcomes
title_sort stroke associated pneumonia (sap) among acute ischaemic stroke patients in hospital universiti sains malaysia : associated factors and clinical outcomes
publishDate 2021
url http://eprints.usm.my/60670/1/SHARIFAH%20NURSAMIHAH-E.pdf
http://eprints.usm.my/60670/
_version_ 1805882513403412480
score 13.211869

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