Serum iron and A(2)DS(2) score in stroke-associated pneumonia

Int J Clin Exp Med. 2015 Apr 15;8(4):6163-70. eCollection 2015.

Abstract

To evaluate the efficacy of serum biomarkers such as iron, procalcitonin (PCT), C-reactive protein (CRP) and A(2)DS(2) scores at hospital admission to predict the onset and severity of stroke-associated pneumonia (SAP), 101 patients with acute stroke were selected and divided into the control and SAP group. Compared with control group, no significant differences were discovered in age, sex, vascular risk factors including hypertension, diabetes and hyperlipidemia, chronic lung disease of SAP group, while a significantly higher level was found in incidence of dysphagia, NIHSS score, A(2)DS(2) score, CURB-65 score, serum iron, serum ferritin, PCT and CRP (P < 0.01). The receiver operating characteristic curve showed that serum iron, serum ferritin, PCT, CRP, A(2)DS(2) score and CURB-65 score had relatively high values in the SAP prediction (all P < 0.01, all AUC > 0.5). When combined ferritin, PCT, and A(2)DS(2) scores and other indicators with CRP for SAP prediction, the model had a larger area under the curve (AUC) and higher specificity than individual prediction models. Spearman regression analysis presented that serum iron, serum ferritin and A(2)DS(2) score were highly correlated with CURB-65 score (P < 0.01). It was suggested that Serum iron and A(2)DS(2) score measured at admission were effective indicators in SAP prediction which could be used for SAP screening and severity prediction. Besides, the specificity in SAP prediction could be improved when Serum iron and A(2)DS(2) score combined with CRP.

Keywords: A(2)DS(2) score; C-reactive protein; CURB-65 score; Stroke-associated pneumonia; procalcitonin; serum iron.