Although poststroke dysphagia has been shown to be associated with aspiration pneumonia (AP), the prevalence and influencing factors of AP in stroke patients with dysphagia are still not entirely clear. This study aims to explore the prevalence and influencing factors of AP in stroke patients with dysphagia and to establish a nomogram model. This retrospective study included stroke patients with dysphagia from 2020 to 2024. Information was collected on basic data, nutritional status, swallowing function, blood routine tests, Barthel index and AP. Univariate and the multivariate analyses were used to identify the influencing factors of AP. A nomogram model was developed, and internal validation was conducted using k -fold cross-validation while external validation was conducted using the data from an additional database. Totally, 761 participants were included, with an AP prevalence of 31.41%. After adjusting for potential confounders, age (56–65: adjusted odds ratio aOR 95% confidence interval CI: 1.756 1.132, 2.724; 66–75: aOR 95% CI: 2.313 1.300, 4.116; >75: aOR 95% CI: 2.928 1.552, 5.525), denture status (wearing: aOR 95% CI: 1.429 1.115, 2.096), paralysis (hemiplegia: aOR 95% CI: 1.676 1.104, 2.544; quadriplegia: aOR 95% CI: 1.829 1.184, 2.826), nutrition support mode (intermittent oro-esophageal tube feeding: aOR 95% CI: 0.552 0.377, 0.807), stroke location (brainstem: aOR 95% CI: 1.634 1.173, 2.276), history of reflux esophagitis (yes: aOR 95% CI:1.979 1.372, 2.855), National Institutes of Health Stroke Scale (≤5: aOR 95% CI: 1.921 1.226, 3.009; 6–20: aOR 95% CI: 3.154 1.902, 5.230; >20: aOR 95% CI: 0.856 0.781, 0.939), mini-mental state examination (aOR 95% CI: 0.856 0.781, 0.939), malnutrition (yes: aOR 95% CI: 1.424 1.099, 2.399), penetration-aspiration scale (aOR 95% CI: 1.479 1.344, 7.987), neutrophil percentage (>70%: aOR 95% CI: 1.929 1.186, 3.3136), white blood cell count (abnormal: aOR 95% CI: 2.019 1.247, 3.270), and Barthel index (aOR 95% CI: 0.948 0.910, 0.988) were the independent factors associated with AP in stroke patients with dysphagia. K -fold cross-validation revealed a mean area under curve of 0.729. The C-index for the training set and validation set were 0.778 and 0.748, respectively, and the model exhibited good stability and accuracy. The decision curve analysis revealed a net benefit when the risk threshold was between 0 and 0.85. The nomogram can help identify the risk of AP in stroke patients with dysphagia.
Zeng et al. (Fri,) studied this question.