Global prevalence of stroke-associated pneumonia: a systematic review and meta-analysis of cross-sectional studies.

BACKGROUND

Neurological damage resulting from stroke can impair the respiratory system, leaving stroke patients susceptible to pulmonary complications, such as stroke-associated pneumonia (SAP). Due to the substantial mortality risk associated with SAP and its complications, we conducted a systematic review and meta-analysis to estimate the global prevalence of SAP.

METHOD: A comprehensive search of MEDLINE via PubMed, EMBASE, Scopus, and Web of Science was conducted from 1 January 2014 to 7 August 2024. The cross-sectional studies were selected. The primary study outcome was the prevalence of SAP. Subgroup analysis was implemented. The random-effects method was used to implement meta-analysis. The Joanna Briggs Institute tool for prevalence was used to assess risk of bias in the included studies.

RESULT: A comprehensive search of MEDLINE via PubMed, EMBASE, Scopus, and Web of Science was conducted from 1 January 2014 to 7 August 2024. The cross-sectional studies were selected. The primary study outcome was the prevalence of SAP. Subgroup analysis was implemented. The random-effects method was used to implement meta-analysis. The Joanna Briggs Institute tool for prevalence was used to assess risk of bias in the included studies. Result The present systematic review and meta-analysis integrated data from 24 studies, encompassing 4,272,805 participants. The prevalence of SAP was 18.3% (95% CI: 13.7-23.0). Results showed significant heterogeneity among studies regarding prevalence estimates (I2= 99.74%, p<0.001). Subgroup analysis by country revealed a substantial reduction in heterogeneity within one specific subgroup (I2=0.00, P=0.67). Utilizing Begg's and Egger's tests showed no statistically significant evidence (P = 0.9013 and P = 0.8398, respectively) of publication bias. The trim-and-fill analysis did not impute additional studies, implying that publication bias is unlikely. A leave-one-out sensitivity analysis revealed that excluding the study by Asgedom et al. resulted in the most significant change in the overall prevalence of SAP.

CONCLUSION

Our results emphasized the need to effectively identify and manage risk factors to reduce the likelihood of SAP.