Risk factors for pulmonary infection in elderly patients with acute stroke: A meta-analysis

Objective: The study aims to systematically evaluate the risk factors of pulmonary infection in elderly patients with acute stroke. Methods: PubMed, CENTRAL, CINAHL, Web of Science, Embase, and four Chinese databases (CNKI, SinoMed, VIP, and Wanfang databases) for studies involving risk factors of pulmonary infection in elderly patients with acute stroke were searched. Then, two researchers independently read the article titles and abstracts to screen the literature, extracted relevant research data, and evaluated the methodological quality. Finally, a meta-analysis was performed. Results: In total, fifteen studies were included, with medium and high-grade quality. Meta-analysis results showed: age [OR = 1.70, 95% CI (1.27, 2.29), P = 0.0004], type of stroke [OR = 1.30, 95% CI (1.21, 1.40), P < 0.00001], conscious disturbance [OR = 2.27, 95% CI (1.44, 3.58), P = 0.0004], dysphagia [OR = 3.24, 95% CI (2.06, 5.12), P < 0.00001], diabetes mellitus [OR = 2.35, 95% CI (1.23, 4.48), P = 0.010], hypertension [OR = 2.05, 95% CI (1.83, 2.31), P < 0.0001], chronic obstructive pulmonary disease (COPD) [OR = 2.69, 95% CI (1.90, 3.81), P < 0.00001], hyperlipidemia [OR = 1.29, 95% CI (1.19, 1.39), P < 0.00001], invasive procedure [OR = 3.37, 95% CI (2.30, 4.94), P < 0.00001], hospital stays [OR = 1.41, 95% CI (1.22, 1.62), P < 0.00001], bedridden time [OR = 1.51, 95% CI (1.36, 1.68), P < 0.00001], and National Institute of Health Stroke Scale (NIHSS) score [OR = 1.67, 95% CI (1.02, 2.75), P = 0.04] were independent risk factors. Glasgow Coma Scale (GCS) score was not a risk factor. However, the relationship between atrial fibrillation, smoking history, and pulmonary infection in elderly patients with acute stroke needs further proof.Conclusions: Age, type of stroke, conscious disturbance, dysphagia, diabetes mellitus, hypertension, COPD, hyperlipidemia, invasive procedure, hospital stays, bedridden time, and NIHSS score were risk factors for pul-monary infection in elderly patients with acute stroke.

Automated summary

The study systematically evaluated the risk factors of pulmonary infection in elderly patients with acute stroke, identifying age, type of stroke, conscious disturbance, dysphagia, diabetes mellitus, hypertension, COPD, hyperlipidemia, and other factors as independent risk factors. Further investigations are needed to confirm the relationship between atrial fibrillation, smoking history, and pulmonary infection risk.