Serum albumin as a potential predictor of pneumonia after acute ischemic stroke.

Serum albumin level is associated with infection after stroke, but whether albumin predicts poststroke pneumonia is unclear. Here we evaluated the potential relationship between albumin level and pneumonia in patients with acute ischemic stroke (AIS).A consecutive sample of 798 AIS patients who were admitted to West China Hospital within 24 h after onset between 2017 and 2018 were retrospectively analyzed. Blood was collected on admission and assayed for serum albumin. Univariate analyses, multivariate logistic regression, and stratified logistic regression were performed to identify risk factors of post-stroke pneumonia.Of the 798 patients, 240 (30.2%) developed pneumonia at a median of 48 h after onset (interquartile range, 27-74 h). Patients with pneumonia had significantly lower serum albumin level than those without pneumonia (40.6 vs. 42.9 g/l, p < 0.001). After adjustment, albumin level was still significantly associated with pneumonia in multivariate logistic regression (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.81-0.94). The association between serum albumin and pneumonia tended to depend on National Institutes of Health Stroke Scale score (p = 0.045), but this was significant only in patients with mild stroke (OR 0.84, 95% CI 0.77-0.93). A dose-dependent inverse relationship was found between albumin levels and risk of pneumonia after AIS. Albumin values predicted pneumonia with an area under the curve of 0.661 (95% CI 0.620-0.701), and the optimal cutoff was 42.6 g/L.Low serum albumin level may be an independent predictor of pneumonia in patients with AIS, especially in mild stroke. In fact, risk of pneumonia may vary inversely with albumin level.