关键词: 脑梗死, 吞咽障碍, 吸入性肺炎

Abstract: Objective To explore the influencing factors of aspiration pneumonia in elderly patients with dysphagia after cerebral infarction within one month, and to establish a Nomogram prediction model to reduce the incidence of aspiration pneumonia. 
Methods A total of 280 elderly patients with dysphagia after cerebral infarction were selected as research subjects, and randomly divided into modeling population (n=196) and verification group (n=84) in a 7〖DK〗∶3 ratio. The incidence and clinical data of aspiration pneumonia within 1 month after developing the disease were recorded in modeling group and verification group. The influencing factors of aspiration pneumonia in the modeling group were analyzed by Lasso and Logistic analysis, and a Nomogram prediction model was established. The external validation of Nomogram prediction model was performed in the verification group. 
Results The incidence of aspiration pneumonia was 42.86% in the modeling group and 44.05% in the verification group. The risk factors of aspiration pneumonia were advanced age, underlying pulmonary disease, increased score of National Institute of Health Stroke Scale (NIHSS), improper posture, no electromagnetic stimulation treatment, presence of pharyngeal residue, and elevated levels of C-reactive protein (CRP) level in peripheral blood, neutrophil-to-lymphocyte ratio (NLR), and leukocyte-erythrocyte ratio (LER) (P＜0.05). The area under the curve (AUC) of Nomogram prediction model for predicting aspiration pneumonia was 0.957, and the calibration and clinical efficacy were good. 
Conclusion This Nomogram model is established based on the risk factors of aspiration pneumonia in elderly patients with dysphagia after cerebral infarction, including advanced age, underlying pulmonary diseases, increased NIHSS score, improper posture, no electromagnetic stimulation treatment, pharyngeal residue and elevated levels of CRP, NLR and LER in peripheral blood. This model has a certain value in predicting the occurrence of aspiration pneumonia, which is helpful for early clinical screening of high-risk patients and effective prevention and treatment, so as to reduce the occurrence of aspiration pneumonia.

Key words: cerebral infarction, dysphagia, sspiration pneumonia