Abstract
OBJECTIVE: Aspiration pneumonia is a common complication post-stroke that increases the patient's duration of stay in hospital, mortality and morbidity. We examined the incidence, clinical characteristics and outcomes among ischaemic stroke-related aspiration pneumonia patients in Qatar. SETTINGS AND PARTICIPANTS: The Qatar Stroke database was reviewed for patients with acute ischaemic stroke admitted to Hamad General Hospital, a tertiary care medical facility, between January 2014 and April 2024. OUTCOMES: Patients were retrospectively assessed for mortality at 90 days, modified Rankin Score at 90 days and length of stay. Several clinical characteristics were also compared between patients with acute ischaemic stroke who developed aspiration pneumonia versus those without. RESULTS: Patients with stroke who developed aspiration pneumonia tended to be older and of the male sex. Patients who developed aspiration pneumonia were also more likely to present with a higher National Institute of Health Stroke Scale (NIHSS) at admission (p<0.001). Patients with large vessel disease, cardioembolic stroke, stroke of determined aetiology and stroke of undetermined aetiology were more likely to develop aspiration pneumonia. They also stayed an average of 10 days longer in the hospital compared with patients without aspiration pneumonia (16.0 vs 5.3 days). Patients admitted to the medicine ward had higher odds of developing aspiration pneumonia in contrast to patients admitted to the stroke ward (adjusted OR of 1.56, 95% CI: 1.05 to 2.31). Patients with aspiration pneumonia had unfavourable outcomes (modified Rankin Scale 3-6) at 90 days (74.6% vs 30.4% for an NIHSS admission score of 5-9 and 79.6% vs 59.5% for an NIHSS admission >10). They were also more likely to have higher mortality rates at 90 days (16.9% vs 1.9% for an NIHSS admission score of 5-9 and 22.3% vs 13.8% for an NIHSS admission score >10) and major adverse cardiovascular events at 1 year (23.7% vs 3.8% for an NIHSS admission score of 5-9 and 27.5% vs 16.2% for NIHSS>10). CONCLUSION: Age, sex, admission NIHSS severity, stroke subtypes and admission location are independent predictors of aspiration pneumonia post-stroke.