A2DS2%score%to%predict%stroke0associated%pneumonia%in%a%French%stroke%unit%

Dr(E.CUGYa,(M.ENGELHARDTb,(Pr(PA.JOSEPHc,(Pr(I.SIBONd ((

a(Service(de(Médecine(Physique(et(Réadapta1on,(CH(Arcachon,(La(Teste(de(Buch,(France(
b(Service(de(Médecine(Physique(et(Réadapta1on,(CHU(Pellegrin,(Bordeaux,(France ((
c(EA(4136,(Université(de(Bordeaux,(Bordeaux,(France(
d(Unité(Neuro6Vasculaire,(CHU(Pellegrin,(Bordeaux,(France(

Background( –( Stroke6associated( pneumonia( is( a( leading( cause( of( in6hospital( death( following( stroke.[1]( Moreover(
pa1ents( with( stroke6associated( pneumonia( show( poorer( func1onal( outcome.[2]( Screening( pa1ents( at( high( risk( is(
one(of(the(main(challenges(in(acute(stroke(units.(A2DS2(score(predicts(post6stroke(pneumonia(based(on(rou1nely(
available(data,(but(was(only(evaluated(in(Germany([3](and(China([4].(

Objec-ve( –( The( aim( of( our( study( was( to( test( the( A2DS2( Results( –( Pneumonia( was( observed( in( 5%( of(
score(in(a(popula1on(of(ischemic(stroke(pa1ents(admimed( pa1ents( and( caused( in6hospital( fatality( in( 2%.(
in(a(French(stroke(unit.( Stroke6associated(pneumonia(ranged(from(1.1%(in(
pa1ents(with(lower(A2DS2(score((064)(to(23.5%(in(
Method( –( 1815( consecu1ve( pa1ents( with( acute( ischemic( those(with(higher(score((5610)((p(<(0.0001).(
stroke( admimed( in( our( ter1ary( center( hospital( stroke( unit(
from(July(2013(to(June(2014(were(retrospec1vely(analysed(
with( A2DS2( score.( Only( in6hospital( pneumonia( and( death(
rate(were(considered.(

Table( 1( –( Calcula1ng( A2DS2( score( (ordinal( scale,( 0610( points).(

NIHSS,=,Na>onal,Ins>tutes,of,Health,Stroke,Scale,

Clinical(variables( Points((
Age(≥(75(years( +(1(
Atrial(Fibrilla1on,(presence( +(1(
Dysphagia,(presence( +(2(
Sex,(male( +(1(
Stroke(Severity,(NIHSS( (
(((((0(6(4( +(0(
(((((5(6(15( +(3(
(((((≥(16( +(5(
Figure( 1( 6( Risk( of( stroke6associated( pneumonia( and(
mortality(during(hospitaliza1on(according(to(A2DS2((
Table(2(–(Popula1on(characteris1c(.(LES,=,Length,of,stay,

With( Without(
Total((
pneumonia( pneumonia(
Nb(pa1ents( 1815( 90( 1725( Conclusion(–(A2DS2(score(might(be(useful(to(predict(
((((((((((men((n,%)( 984((54)( 54((60)( 930((54)( stroke6associated( pneumonia( in( stroke( pa1ents(
Age((mean(±(SD)(( 65.27(±(17.00( 74.20(±(12.88( 64.81(±(17.06( treated(in(French(early(care(stroke(unit.(
ACFA((n,%)( 204((11)( 28((31)( 176((10)(
Dysphagia((n,%)( 109((6)( 54((60)( 55((3)(
NIHSS(score((mean(±(SD)(( 4.45(±(6.55( 15.40(±(8.54( 3.89(±(5.92(
LES(in(day((mean(±(SD)(( 6.42(±(9.89( 20.86(±(24.38( 5.66(±(7.80(
References:(
[1]( F.( L.( Silver,( J.( W.( Norris,( A.( J.( Lewis,( and( V.( C.( Hachinski,( “Early( mortality( following(
stroke:( a( prospec1ve( review,”( Stroke, J., Cereb., Circ.,( vol.( 15,( no.( 3,( pp.( 492–496,( Jun.(
Table(3(–(Risk(of(stroke6associated(pneumonia(and(mortality( 1984.(
[2]( W.( F.( Westendorp,( P.( J.( Nederkoorn,( J.6D.( Vermeij,( M.( G.( Dijkgraaf,( and( D.( van( de(
during( hospitaliza1on( according( to( A2DS2( subgroups., , SAP, =, Beek,(“Post6stroke(infec1on:(a(systema1c(review(and(meta6analysis.,”(BMC,Neurol.,(vol.(
Stroke,Associated,Pneumonia, 11,(2011.(
[3](S.(Hoffmann,(U.(Malzahn,(H.(Harms,(H.6C.(Koennecke,(K.(Berger,(M.(Kalic,(G.(Walter,(A.(
A2DS2( Nb( SAP(( Length(of(stay( Mortality(( Meisel,( and( P.( U.( Heuschmann,( “Development( of( a( clinical( score( (A2DS2)( to( predict(
score( pa1ents( (n,(%)( (day)( (n,%)( pneumonia( in( acute( ischemic( stroke,”( Stroke, J., Cereb., Circ.,( vol.( 43,( no.( 10,( pp.( 2617–
2623,(Oct.(2012.(
0(6(4( 1500( 16((1.1)( 4.83(±(6.15( 4((0.3)( [4](Y.(Li,(B.(Song,(H.(Fang,(Y.(Gao,(L.(Zhao,(and(Y.(Xu,(“External(Valida1on(of(the(A2DS2(
5(6(10( 315( 74((23.5)( 13.97(±(17.76( 25((7.9)( Score( to( Predict( Stroke6Associated( Pneumonia( in( a( Chinese( Popula1on:( A( Prospec1ve(
Cohort(Study,”(PloS,One,(vol.(9,(no.(10,(2014. ((

Topic:(Stroke(Management( Congress(on(NeuroRehabilita-on/and/Neural/Repair/
Poster(presenta1on( Neurorehabilita1on(and(Neuoscience(Connected(
Abstract(number:(65(
21622(May(2015,(Maastricht,(the(Netherlands(