Low serum transthyretin levels predict stroke-associated pneumonia

Background and aims: Stroke-associated pneumonia (SAP) is commonly seen in ischemic stroke patients. Low transthyretin levels are found to be correlated with stroke. This study aims to investigate the potential relationship between transthyretin levels and SAP. Methods and results: In total, 920 patients were involved in our study. Serum transthyretin levels were measured within 24 h at admission. We defined SAP according to the modified Centers for Disease Control criteria. In the study population, 123 (13.4%, 77 men, 46 women) were diagnosed with SAP. In the multivariable analysis, we found that serum transthyretin levels were signifi-cantly lower in SAP compared with non-SAP patients (231 +/- 80 vs. 279 +/- 75; P < 0.001) after adjusting for confounders. Meanwhile, we discovered that low transthyretin levels (<252 mg/ L) were independently associated with the development of SAP (OR 3.370; 95% CI: 1.763-6.441; P < 0.001). Moreover, patients with SAP had a worse clinical outcome than those without SAP at discharge. In addition, dysphagia, leukocyte count and NLR (neutrophil-tolymphocyte ratio) were also found to be associated with SAP. Conclusion: We found that low transthyretin levels significantly increased the risk of SAP. Patients with high risk of developing SAP could be early identified and prevented timely. (c) 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Automated summary

This study found that low transthyretin levels significantly increased the risk of stroke-associated pneumonia and were independently associated with the development of SAP. Patients with SAP had worse clinical outcomes at discharge, and factors such as dysphagia, leukocyte count, and NLR were also found to be associated with SAP.