The following is a summary of “Predictive value of cytokines combined with human neutrophil lipocalinin acute ischemic stroke-associated pneumonia,” published in the January 2024 issue of Neurology by Zhang et al.
Researchers started a retrospective study to assess whether combining interleukin-6 (IL-6) and human neutrophil lipocalin (HNL) levels could predict stroke-associated pneumonia (SAP) in patients diagnosed with acute ischemic stroke (AIS).
They divided 108 patients into two groups, the pneumonia group (52 cases) and the non-pneumonia group (56 cases), based on whether the patients developed SAP within 7 days of admission. General information, such as age, gender, history of hypertension, diabetes mellitus, cardiovascular disease, dysphagia, smoking, and alcohol history, was compared between the two groups. Clinical data were recorded and compared, including lipid profile, IL-6, homocysteine (Hcy), National Institutes of Health Stroke Scale (NIHSS) score, and HNL. Used multivariate logistic regression to identify AIS-AP risk factors and assessed IL-6 and HNL predictive value alone and combined using ROC curves.
The results showed that dysphagia (OR, 0.018; 95% CI, 0.001 ~ 0.427; P=0.013), elevated NIHSS scores (OR, 0.012; 95% CI, 0.000 ~ 0.434; P=0.016), and heightened levels of IL-6 (OR, 0.014; 95% CI, 0.000 ~ 0.695; P=0.032) and HNL (OR, 0.006; 95% CI, 0.000 ~ 0.280; P=0.009) were independent risk factors for SAP with significant differences (all P<0.05). According to the ROC curve analysis of IL-6, the AUC was 0.881 (95% CI: 0.820 ~ 0.942), with an optimal cutoff value of 6.89 pg/mL, sensitivity of 73.1%, and specificity of 85.7%. In the ROC curve analysis of HNL, the AUC was 0.896 (95% CI: 0.839 ~ 0.954), with the best cutoff value of 99.66 ng/mL, sensitivity of 76.9%, and specificity of 89.3%. The AUC of the combination of IL-6 and HNL increased to 0.952 (95% CI: 0.914 ~ 0.989), with increased sensitivity and specificity to 80.8% and 92.9%, respectively.
They concluded that high IL-6 and HNL flagged AIS patients for SAP, suggesting combined detection for early risk assessment.
Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-023-03488-w