【医脉通】2015+卒中相关性肺炎的诊断建议.pdf

Special Report Diagnosis of Stroke-Associated Pneumonia Recommendations From the Pneumonia in Stroke Consensus Group Craig J. Smith, MD; Amit K. Kishore, MRCP; Andy Vail, MSc; Angel Chamorro, PhD; Javier Garau, PhD; Stephen J. Hopkins, PhD; Mario Di Napoli, MD; Lalit Kalra, PhD; Peter Langhorne, PhD; Joan Montaner, PhD; Christine Roffe, MD; Anthony G. Rudd, FRCP; Pippa J. Tyrrell, MD; Diederik van de Beek, PhD; Mark Woodhead, MD; Andreas Meisel, MD Background and Purpose—Lower respiratory tract infections frequently complicate stroke and adversely affect outcome. There is currently no agreed terminology or gold-standard diagnostic criteria for the spectrum of lower respiratory tract infections complicating stroke, which has implications for clinical practice and research. The aim of this consensus was to propose standardized terminology and operational diagnostic criteria for lower respiratory tract infections complicating acute stroke. Methods—Systematic literature searches of multiple electronic databases were undertaken. An evidence review and 2 rounds of consensus consultation were completed before a final consensus meeting in September 2014, held in Manchester, United Kingdom. Consensus was defined a priori as ≥75% agreement between the consensus group members. Results—Consensus was reached for the following: (1) stroke-associated pneumonia (SAP) is the recommended terminology for the spectrum of lower respiratory tract infections within the first 7 days after stroke onset; (2) modified Centers for Disease Control and Prevention (CDC) criteria are proposed for SAP as follows—probable SAP: CDC criteria met, but typical chest x-ray changes absent even after repeat or serial chest x-ray; definite SAP: CDC criteria me