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| Imaging features of patients in sequelae of cerebral infarction complicated with community acquired pneumonia and construction and validation of prognostic risk score model |
| QU Hengjuan1 WU Shunyi2 HUANG Xiaowei3 YE Yongqiang1 |
1.Department of Radiology, South Taihu Hospital Affiliated to Huzhou College, Zhejiang Province, Huzhou 313000, China;
2.Department of Radiology, the 72nd Military Hospital of Chinese People’s Liberation Army, Zhejiang Province, Huzhou 313000, China;
3.Department of Respiratory, South Taihu Hospital Affiliated to Huzhou College, Zhejiang Province, Huzhou 313000, China |
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Abstract Objective To analyze the imaging features of patients in sequelae of cerebral infarction complicated with community acquired pneumonia (CAP), and to construct and validate prognostic risk score model. Methods A total of 216 sequelae of cerebral infarction complicated with CAP patients from South Taihu Hospital Affiliated to Huzhou College from January 2018 to March 2022 and the 72nd Military Hospital of Chinese People’s Liberation Army from January 2012 to December 2021 were selected. Using random number table method, 216 patients were divided into modeling group (151 cases) and verification group (65 cases) according to the ratio of 7∶3. Death during hospitalization was tracked and divided into death group and survival group. Based on construction data, univariate and multivariate logistic regression were used to analyze the factors in prognosis of sequelae of cerebral infarction complicated with CAP patients; according to the regression coefficient corresponding to each index in the multi-factor regression equation, the risk score model was established; the performance of the model was evaluated by the receiver operating characteristic curve, and the model was validated by the verification group data. Results The fatality rate of 216 sequelae of cerebral infarction complicated with CAP patients was 20.37%, 19.21% in modeling group and 23.08% in verification group. CT showed that the pulmonary infection involved only one lung in the sequelae of cerebral infarction complicated with CAP in 72.69% and both lungs in 27.31%. CT detected lung consolidation in 12.96% and pleural effusion in 21.30%. There were statistically significant differences in age, time from onset to treatment, duration of cerebral infarction, diabetes, mellitus combined with multidrug-resistant gram-negative bacteria (MDR-GNB) infection, moderate and large pleural effusions, neutrophil to lymphocyte ratio (NLR), and lactic acid between death group and survival group (P＜0.05). Duration of cerebral infarction≥5 years (OR=5.284), diabetes mellitus(OR=3.515), combined with MDR-GNB infection (OR=13.821), moderate and large pleural effusion (OR=6.618), NLR＞5.85 (OR=8.186), and lactic acid ＞2.66 mmol/L (OR=4.699) were independent risk factors for affecting prognosis of sequelae of cerebral infarction complicated with CAP patients (P＜0.05). The area under the curve of risk score model in construction risk score model in the modeling group and the verification group was 0.804 (95%CI: 0.731-0.864) and 0.821 (95%CI: 0.706-0.905), respectively. ≥5 points was classified as high risk of death. Conclusion The risk score model constructed in this study has a good predictive ability for evaluating the prognosis of sequelae of cerebral infarction complicated with CAP patients.
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