Impact of Dyslipidemia, Cardiovascular Disease, Smoking, and Stroke Type by Brain Imaging on Pneumonia Risk in ICU Stroke Patients: A Cross-Sectional Observational Study.

Abstract

Background: Stroke-associated pneumonia (SAP) is an associated condition after stroke and is strongly related to prolonged hospitalization and a high mortality rate. While comorbidities are often assumed to influence pneumonia risk, their role remains uncertain across stroke subtypes. Objective: To identify predictors of pneumonia in ischemic and hemorrhagic stroke patients, with emphasis on age, sex, and common vascular comorbidities. Methods: We analyzed 300 stroke patients who underwent a tertiary care hospitalization, including 237 ischemic and 63 hemorrhagic cases. Demographic and clinical variables, such as sex, hypertension, ischemic heart disease, smoking, and dyslipidemia, were assessed. Pneumonia occurrence was the primary outcome. Chi-square tests and binary logistic regression were used to identify independent predictors. Results: Pneumonia developed in 55% of ischemic stroke patients and 17.5% of those with hemorrhagic stroke. In ischemic stroke, age was the only independent predictor of pneumonia (OR: 1.01; 95% CI: 1.00-1.03; p = 0.042). Sex and comorbidities showed no significant associations. In hemorrhagic stroke, none of the evaluated variables predicted pneumonia. Conclusion: Post-stroke pneumonia was more common in ischemic than hemorrhagic stroke. Age was the sole independent predictor among ischemic patients, while traditionally assumed comorbidities were not significant. Preventive strategies should focus on older ischemic patients, incorporating systematic aspiration screening and targeted pulmonary care. A bigger prospective multicenter data evaluation is needed to validate and expand these findings.