摘要目的:比较博洛尼亚卒中结局算法（BOAS）、洛桑卒中量表（ASTRAL）及院前合并症、意识水平、年龄和神经功能缺损（PLAN）评分对ICU老年脑卒中患者卒中相关性肺炎（SAP）和预后的预测价值。方法:采用便利抽样法，选取2017年6月—2019年12月在河南省人民医院神经内科ICU住院的198例老年脑卒中患者作为研究对象，按照4周内是否发生SAP将患者分为SAP组和非SAP组、重症SAP亚组和轻症SAP亚组，并按照4周内结局分为预后不良组和预后良好组；记录并比较不同分组间BOAS、ASTRAL及PLAN评分的差异，采用ROC曲线分析比较3种量表对SAP及其预后的预测性能。结果:BOAS、ASTRAL及PLAN评分间两两分别呈正相关（ P<0.05）；SAP组3种评分均高于非SAP组，且重症SAP亚组ASTRAL、PLAN评分高于轻症SAP亚组，差异均有统计学意义（ P<0.05）。BOAS、ASTRAL及PLAN评分预测SAP的ROC曲线下面积（ AUC）分别为0.610、0.692和0.705，预测重症SAP的 AUC分别为0.613、0.661和0.709；在SAP组和非SAP组内，预后不良组患者的3种评分均高于预后良好组，差异均有统计学意义（ P<0.05），SAP组内BOAS、ASTRAL及PLAN评分预测不良预后的 AUC分别为0.736、0.757和0.716，在非SAP组内 AUC分别为0.699、0.731和0.631。 结论:BOAS、ASTRAL及PLAN评分对ICU内老年患者的SAP及其预后有一定预测价值，其中PLAN评分对SAP的预测性能、ASTRAL对预后的预测性能较好。

abstractsObjective:To compare the predictive values of Bologna Outcome Algorithm for Stroke (BOAS) , Acute Stroke Registry and Analysis of Lausanne (ASTRAL) and Preadmission Comorbidities, Level of Consciousness, Age, and Focal Neurologic Deficit (PLAN) for stroke-associated pneumonia (SAP) and prognosis in elderly stroke patients in ICU.Methods:Using the convenient sampling method, a total of 198 elderly stroke patients who were hospitalized in ICU of Neurology Department of Henan Provincial People's Hospital were selected as the research objects from June 2017 to December 2019. According to whether SAP occurred within 4 weeks, patients were divided into SAP group, non-SAP group, severe SAP subgroup and mild SAP subgroup. According to the outcome within 4 weeks, they are divided into the poor prognosis group and the good prognosis group. The differences of BOAS, ASTRAL and PLAN scores among different groups were recorded and compared. ROC curve was used to analyze and compare the predictive performance of the three scales for SAP and its prognosis.Results:Pairwise positive correlation was found between BOAS, ASTRAL and PLAN scores ( P<0.05) . All the three scores of patients in SAP group were significantly higher than those in the non-SAP group, and ASTRAL and PLAN scores in severe SAP subgroup were higher than those in mild SAP subgroup, and the differences were significant ( P<0.05) . The area under ROC curve ( AUC) of BOAS, ASTRAL and PLAN scores were respectively 0.610, 0.692 and 0.705, and the AUC for predicting severe SAP were respectively 0.613, 0.661 and 0.709. In the SAP group and the non-SAP group, the scores of three scales of patients in the poor prognosis group were higher than those in the good prognosis group, and the differences were significant ( P<0.05) . The AUC of BOAS, ASTRAL and PLAN scores in the SAP group for predicting poor prognosis were respectively 0.736, 0.757 and 0.716, and AUC in the non-SAP group were respectively 0.699, 0.731 and 0.631. Conclusions:BOAS, ASTRAL and PLAN scores have certain predictive value for the SAP and prognosis of elderly patients in ICU. Among them, PLAN score has better predictive performance for SAP and ASTRAL has better predictive performance for prognosis.