ArticleInternational journal of stroke : official journal of the International Stroke Society2022
Variation of stroke-associated pneumonia in stroke units across England and Wales: A registry-based cohort study.
Article in International journal of stroke : official journal of the International Stroke Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- European stroke organisation guideline on stroke-associated pneumonia.European stroke journal · 2026Guideline
- Comparison of six risk scores for stroke-associated pneumonia in patients with acute ischemic stroke: A systematic review and Bayesian network meta-analysis.Frontiers in medicine · 2022Pooled it
- Electroacupuncture-Induced Phrenic Nerve Stimulation for Poststroke Pneumonia: A Propensity Score Matching Analysis.BioMed research international · 2026Article
- Frailty combined with nutritional risk for predicting stroke-associated pneumonia: a cohort study based on a nomogram model.Frontiers in neurology · 2026Article
- Sex Modifies the Association Between Neutrophil Percentage-to-Albumin Ratio and Stroke-Associated Pneumonia in Acute Ischemic Stroke.Journal of inflammation research · 2026Article
- Stroke-associated pneumonia in Japanese acute care settings: incidence and preliminary validation of risk prediction scores.BMC neurology · 2025Article
- Chest computed tomography and multi-criteria decision analysis-guided interventions for stroke-associated pneumonia in acute ischemic stroke.Revista da Associacao Medica Brasileira (1992) · 2025Article
- A Novel Nomogram for Predicting the Risk of Pneumonia After Intracerebral Hemorrhage.Journal of inflammation research · 2025Article
- Gut microbiota dysbiosis drives stroke-associated pneumonia: mechanisms and targeted therapeutic strategies.Frontiers in neuroscience · 2025Review
- Bacterial stroke-associated pneumonia: microbiological analysis and mortality outcome.BMC neurology · 2024Article
- Serial ASPECTS to predict stroke-associated pneumonia after thrombolysis in patients with acute ischemic stroke.Frontiers in neurology · 2024Article
- Development and validation of a predictive model for stroke associated pneumonia in patients after thrombectomy for acute ischemic stroke.Frontiers in medicine · 2024Article
- Stroke-associated pneumonia according to mCDC criteria: impact on prognosis and antibiotic therapy.Frontiers in neurology · 2024Article
- Does stroke-associated pneumonia play an important role on risk of in-hospital mortality associated with severe stroke? A four-way decomposition analysis of a national cohort of stroke patients.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Influencing factors associated with oral health among older hospitalized patients with ischemic stroke: A cross-sectional survey.International journal of nursing sciences · 2023Article
- The Timing of Stroke Care Processes and Development of Stroke Associated Pneumonia: A National Registry Cohort Study.Frontiers in neurology · 2022Article
- C-reactive protein to albumin ratio as a novel predictor of stroke-associated pneumonia: a retrospective cohort study revealing non-linear threshold effects.Frontiers in neurologyArticle
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia is common in stroke patients and is associated with worse clinical outcomes. Prevalence of stroke-associated pneumonia varies between studies, and reasons for this variation remain unclear. We aimed to describe the variation of observed stroke-associated pneumonia in England and Wales and explore the influence of patient baseline characteristics on this variation.
methodsPatient data were obtained from the Sentinel Stroke National Audit Programme for all confirmed strokes between 1 April 2013 and 31 December 2018. Stroke-associated pneumonia was defined by new antibiotic initiation for pneumonia within the first seven days of admission. The probability of stroke-associated pneumonia occurrence within stroke units was estimated and compared using a multilevel mixed model with and without adjustment for patient-level characteristics at admission.
resultsOf the 413,133 patients included, median National Institutes of Health Stroke Scale was 4 (IQR: 2-10) and 42.3% were aged over 80 years. Stroke-associated pneumonia was identified in 8.5% of patients. The median within stroke unit stroke-associated pneumonia prevalence was 8.5% (IQR: 6.1-11.5%) with a maximum of 21.4%. The mean and variance of the predicted stroke-associated pneumonia probability across stroke units decreased from 0.08 (0.68) to 0.05 (0.63) when adjusting for patient admission characteristics. This difference in the variance suggests that clinical characteristics account for 5% of the observed variation in stroke-associated pneumonia between units.
conclusionsPatient-level clinical characteristics contributed minimally to the observed variation of stroke-associated pneumonia between stroke units. Additional explanations for the observed variation in stroke-associated pneumonia need to be explored which could reduce variation in antibiotic use for stroke patients.
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