The impact of post-stroke pneumonia on survival and functional outcomes: A systematic review and meta-analysis

Abstract

Objective: To evaluate the impact of stroke-associated pneumonia (SAP) on mortality risk and poor functional outcomes.

Methodology: PubMed, Embase and Scopus databases were searched to identify studies with adult stroke patients (≥40 years) who were diagnosed with SAP. Risk of mortality and poor functional outcome were of primary interest. Results were reported as pooled odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI).

Results: A total of 22 studies were included. SAP was associated with the increased risk of in-hospital mortality (OR 2.67, 95% CI: 1.82, 3.93) and mortality at one (OR 2.11, 95% CI: 1.17, 3.79), two (OR 6.97, 95% CI: 4.63, 10.5) and three months (OR 4.26, 95% CI: 2.44, 7.44) of follow up compared to stroke patients without SAP. Risk of mortality at ≥1 year of follow up was also higher in patients with SAP (HR 2.44, 95% CI: 1.33, 4.48). SAP also correlated with the increased risk of poor functional outcome (OR 4.82, 95% CI: 3.47, 6.69)

Conclusion: SAP is associated with significant adverse impact on survival and functional outcomes of stroke patients and further strengthen the need for a comprehensive approach to stroke management.