+1. Aspiration pneumonia in post-stroke patients showed significantly increased 90-day mortality, longer hospital stays, and more cardiovascular events at one year
+This retrospective cohort study analyzed the impact of stroke severity on the risk of aspiration pneumonia in patients admitted to a stroke unit versus a general medical ward. Using data from the Qatar Stroke Database, 9,197 patients with acute ischemic stroke admitted between 2014 and 2024 were reviewed. The study compared clinical characteristics, 90-day mortality, functional outcomes (modified Rankin Scale), and hospital length of stay between stroke patients who developed aspiration pneumonia (4.1%) and those who did not (95.9%). Patients who developed aspiration pneumonia were older, more often male, and had significantly higher National Institute of Health Stroke Scale (NIHSS) scores at admission (p<0.001). Stroke subtype also influenced risk, with large vessel disease, cardioembolic stroke, and undetermined etiology associated with higher pneumonia rates. Patients with aspiration pneumonia had worse outcomes, including higher 90-day mortality (16.9% vs. 1.9% for NIHSS 5–9, p<0.001; 22.3% vs. 13.8% for NIHSS >10, p=0.003), longer hospital stays (16.0 vs. 5.3 days, p<0.001), and more adverse cardiovascular events at one year. Admission to a general medical ward increased pneumonia risk compared to stroke unit admission (adjusted OR 1.56, 95% CI: 1.05-2.31). The study highlights the importance of early dysphagia screening, targeted prevention strategies, and specialized stroke care in reducing aspiration pneumonia risk and improving patient outcomes.
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