Stroke associated pneumonia (SAP) is a common complication in 8 to 13% of stroke survivors. Previous SAP studies have focused on clinical characteristics with limited evidence currently on stroke care processes. Here, we describe the relationship between key markers of acute care process and SAP presence within the first 7 days of care
Patient-level information on all confirmed strokes between 1st April 2013 and 31st December 2018 was obtained from the Sentinel Stroke National Audit Programme (SSNAP). SAP was defined as antibiotic initiation for suspected pneumonia within the first 7 days of admission. Stroke care processes included markers of pre-hospital care, hyper-acute care, acute care and thrombolysis. We then modelled SAP at 7 days in multilevel logistic regression whilst adjusting for a set of predefined clinical confounders and clustering within stroke units
Of 456590 stroke patients present, 39397 (8.63%) were identified with SAP during the first 7 days. The median symptom onset to arrival at hospital time was 166 minutes (Interquartile range 86-505 min), for a swallow screen it was 84 minutes (IQR 44-149), time to be seen by a stroke specialist was 699 minutes (IQR 120 – 1220), and time from symptom onset to thrombolysis was 166 minutes (IQR 86-505)
Final results are to be confirmed. SAP has significant short and long-term patient health implications, a clearer understanding of the non-clinically associated factors could benefit both patients and stroke care facilities, as well as provide a basis for further research in reducing the burden of SAP in stroke patients