Intensive Versus Standard Statin Therapy in Acute Ischemic Stroke: A Comparative Study on the Risk of Pneumonia and Multidrug-Resistant Bacterial Infections

Intensive Versus Standard Statin Therapy in Acute Ischemic Stroke: A Comparative Study on the Risk of Pneumonia and Multidrug-Resistant Bacterial Infections | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Intensive Versus Standard Statin Therapy in Acute Ischemic Stroke: A Comparative Study on the Risk of Pneumonia and Multidrug-Resistant Bacterial Infections Zhijun Wen, Zhenming Yang, Jianhua Cheng, Yirui Huang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8842936/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The use of intensive statin therapy in acute ischemic stroke (AIS) is common; however, its association with post-stroke pneumonia (PSP) remains uncertain. This study aimed to determine whether intensive-dose atorvastatin (≥ 40 mg/d) increases the risk, severity, or incidence of multidrug-resistant (MDR) bacterial infections in PSP compared to standard-dose therapy (20 mg/d). Methods We retrospectively analyzed 4,843 AIS patients admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022. After applying inclusion and exclusion criteria, 3,199 patients were included. Propensity score matching (PSM) was used to balance baseline characteristics between the intensive and standard atorvastatin groups. The incidence of PSP, pneumonia severity (evaluated by CURB-65 scores), and MDR bacterial infection rates were compared. Multivariate logistic regression was applied to identify independent risk factors for PSP. Results After PSM, no significant difference was observed in PSP incidence between the intensive and standard atorvastatin groups (8.8% vs. 8.3%, p = 0.691). Multivariate regression confirmed that intensive treatment was not associated with increased PSP risk, either before (OR = 1.074, 95% CI: 0.756–1.525) or after matching (OR = 1.002, 95% CI: 0.672–1.492). Among the 173 PSP patients, there were no significant differences in the proportion of severe pneumonia (21.4% vs. 20.2%, p = 0.863) or MDR bacterial infection incidence (9.5% vs. 10.1%, p = 0.897) between the two groups. Conclusions Intensive atorvastatin treatment during the acute phase of ischemic stroke did not increase the risk or severity of pneumonia, nor did it elevate MDR bacterial infections. These findings support the safe use of statins in AIS patients and offer insights for optimizing clinical treatment strategies. Clinical trial number: Not applicable. Atorvastatin Intensive treatment Post-stroke pneumonia Ischemic stroke Figures Figure 1 Introduction Stroke as the leading cause of death in China, is often complicated by post-stroke infections, particularly post-stroke pneumonia (PSP) 1 , which can lead to clinical deterioration and increased mortality 2 – 4 . PSP not only significantly prolongs hospital stays but also elevates the risk of patient death. The prevention and management of PSP have become crucial for improving stroke outcomes. Current clinical attempts, such as prophylactic antibiotic therapy 5 and β-blocker intervention 6 , have failed to effectively reduce the incidence of PSP. Based on the "stroke-induced immunodepression" theory, immunomodulation may emerge as a novel preventive and therapeutic direction 7 . Statins are cornerstone drugs in the early treatment of acute ischemic stroke. Beyond their lipid-lowering effects, statins possess anti-inflammatory, immunomodulatory, antioxidant, and endothelial-stabilizing properties 8 , 9 . However, the relationship between these pleiotropic effects and the risk of post-stroke pneumonia remains controversial. Existing research findings can be broadly categorized into three groups: (1) Increased risk of PSP 10 : Becker et al. found that early statin use (within 3 days) after ischemic stroke might be associated with an increased risk of infection within the subsequent 15 days (OR = 7.21). (2) No effect on PSP 11 , 12 : Rodríguez et al. found that prior statin use did not seem to affect the frequency of in-hospital infections in ischemic stroke patients, and Li et al. found no additional benefit in reducing PSP for AIS patients using statins in the acute phase compared to non-users. (3) Reduced risk of PSP 13 – 15 : Scheitz et al. found that continued statin use (compared to non-use) in patients with acute ischemic stroke receiving thrombolytic therapy might be associated with a reduced risk of PSP, although its impact on long-term functional outcomes and mortality was not significant. In-depth analysis suggests that differences in the type and dosage of statins used may be key underlying factors contributing to these inconsistent conclusions. For instance, a study on the impact of different statin doses on sepsis outcomes found that the beneficial effect of pre-administrated statins on sepsis outcomes significantly increased with higher doses 16 . Another study found that statin therapy in the acute phase of ischemic stroke did not appear to increase the risk or severity of PSP. The authors of that study further suggested that the lack of consideration for specific statin types and dosages might explain this finding 12 . Current guidelines for the early treatment of acute ischemic stroke recommend routine intensive statin therapy for lipid lowering 17 . However, against the backdrop of the increasing adoption of intensive statin therapy, and given the pleiotropic effects of statins in acute ischemic stroke along with the aforementioned research controversies, the specific impact of particular dosages (especially intensive doses) on PSP risk remains inadequately studied. Previous research has primarily compared statin use versus non-use regarding PSP risk. Furthermore, there is a lack of systematic investigation into whether intensive statin therapy in the acute phase affects the etiological distribution of PSP or the prevalence of drug-resistant bacteria. This study aims to investigate the effects of different doses of atorvastatin on post-stroke pneumonia, thereby providing relevant evidence for clinical treatment strategies. Material and methods Study Population We retrospectively collected clinical data of patients with Acute Ischemic Stroke (AIS) admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022 from the electronic medical record system. Patients who met the following inclusion criteria were enrolled: (1) Diagnosis of AIS according to the criteria established by the Chinese Society of Neurology 18 ; (2) Age ≥ 18 years; (3) Time from onset to admission ≤ 3 days. The exclusion criteria were as follows: (1) History of prior stroke or transient ischemic attack (TIA); (2) Prophylactic antibiotic treatment administered pre-stroke or during the stroke hospitalization; (3) Pre-existing infectious, autoimmune diseases, or any malignancies; (4) Pre-stroke statin medication use; (5) Pregnancy; (6) Infections during the stroke hospitalization other than PSP; (7) Severe hepatic or renal dysfunction; (8) Incomplete clinical data. Ethical Considerations This study was approved by the Ethics Committee of the First Affiliated Hospital of Wenzhou Medical University and was conducted in accordance with the principles of the Declaration of Helsinki. As a retrospective observational study that met the following conditions: (1) all data were derived from de-identified archival information from the hospital's electronic medical record system; (2) the research process involved no additional interventions; (3) data analysis was performed on a fully anonymized dataset (with sensitive information such as names and ID numbers removed); and (4) the study results would not disclose individual patient treatment details, the Ethics Committee granted a waiver of informed consent in compliance with the Declaration of Helsinki and relevant Chinese regulations ("Ethical Review Measures for Biomedical Research Involving Humans"). The entire study adhered to the "Management Specifications for Privacy and Data Sharing in Medical Research (2021 Edition)." Methods Data Collection Baseline characteristics were collected from electronic medical records, including: Demographic parameters: Age and gender. Clinical characteristics: Systolic blood pressure, diastolic blood pressure, respiratory rate, presence of nasogastric tube, endotracheal intubation or tracheostomy, dysphagia, admission NIHSS score, and length of hospital stay. Medical history: Smoking history, alcohol consumption history, hypertension, diabetes mellitus, coronary heart disease, atrial fibrillation, and chronic obstructive pulmonary disease (COPD). Laboratory parameters: White blood cell count, lymphocyte count, serum albumin level, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and blood Urea nitrogen. Imaging characteristics: TOAST ((Trial of ORG 10172 in Acute Stroke Treatment). classification and stroke location (anterior circulation, combined anterior/posterior circulation, and posterior circulation). Definition of Intensive Atorvastatin treatment Based on a previous study 19 and the American Heart Association's definition for intensive atorvastatin treatment 20 , intensive treatment in this study was defined as the administration of atorvastatin at a dose ≥ 40 mg/d, initiated within 72 hours of symptom onset (acute phase). The standard treatment was defined as 20 mg/d. Diagnostic Criteria for Post-Stroke Pneumonia 21 PSP was diagnosed based on the presence of new or progressive infiltrative changes on chest imaging after stroke onset, plus at least two of the following clinical symptoms/signs: (1) New or worsened cough/sputum production, with or without chest pain; (2) Signs of pulmonary consolidation and/or moist rales; (3) Fever (body temperature ≥ 38°C); (4) White blood cell count ≥ 10×10⁹/L or ≤ 4×10⁹/L, with or without a left shift. Conditions with similar clinical presentations, such as lung cancer, pulmonary tuberculosis, pulmonary edema, atelectasis, non-infectious interstitial lung disease, and pulmonary embolism, were rigorously excluded. Severity of Post-Stroke Pneumonia 22 The severity of PSP was assessed using the CURB-65 score during hospitalization. A CURB-65 score ≥ 3 was defined as severe pneumonia. The CURB-65 score is calculated as follows (1 point for each): (1) Confusion; (2) Blood Urea nitrogen > 7 mmol/L; (3) Respiratory rate ≥ 30 breaths/min; (4) Systolic blood pressure < 90 mmHg or Diastolic blood pressure ≤ 60 mmHg; (5) Age ≥ 65 years. Definition of Multidrug-Resistant Organisms According to a currently internationally authoritative and widely cited definitive publication 23 , multidrug-resistant organisms (MDROs) in this study were defined as bacteria acquiring resistance to three or more classes of antimicrobial agents listed in the antimicrobial spectrum classification. Statistical Analysis Statistical analysis and graphing were performed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp, Armonk, NY, USA). The Kolmogorov-Smirnov test was used to assess the normality of continuous variables. Normally distributed continuous variables were compared using Student's t-test and one-way ANOVA, expressed as mean ± standard deviation. For non-normally distributed continuous variables, the Mann-Whitney U test was used to assess differences between two groups, expressed as median (interquartile range). Categorical variables were analyzed using the Chi-square test or Fisher's exact test, expressed as number (n) and percentage (%). Spearman correlation analysis was used to explore the correlation between two non-normally distributed variables. The significance level was set at a two-tailed p-value < 0.05. Logistic regression analysis was used to analyze the relationship between the occurrence of post-stroke pneumonia and intensive atorvastatin treatment during the acute phase. Multivariable logistic regression analysis included all variables with p < 0.05 in univariable logistic regression and covariates previously associated with PSP in the literature. The logistic regression models were analyzed before and after propensity matching, respectively. All tests were two-sided, and p < 0.05 was considered statistically significant. Propensity Score Matching (PSM) The propensity score was obtained using logistic regression, with intensive atorvastatin treatment during the acute phase as the dependent variable. Nearest neighbor matching was performed for 1:1 matching without replacement, matching patients in the intensive atorvastatin treatment group with those in the standard atorvastatin treatment group using a caliper width of 0.02. Variables used in the propensity matching process were: Age, gender, smoking history, alcohol history, history of hypertension, history of atrial fibrillation, history of coronary heart disease, consciousness disorder, presence of nasogastric tube, tracheal intubation/tracheostomy, stroke location, TOAST classification, lymphocyte count, albumin, triglycerides, LDL-C, HDL-C. Results Baseline Characteristics During the study period, a total of 4843 patients with acute ischemic stroke who were admitted to and treated in the Department of Neurology at the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022 were initially identified (Fig. 1 ). After applying the inclusion and exclusion criteria, 3199 patients were ultimately included in the analysis. In all patients, 2101 were males (65.7%), with a mean age of 68.00 (58.00,76.00) years. A total of 2157 (67.4%) patients received intensive atorvastatin treatment in the acute phase, and 1042 (32.6%) patients received standard atorvastatin treatment in the acute phase. Among the included cohort of 3199 patients, 243 (7.6%) patients developed pneumonia after acute ischemic stroke. Baseline characteristics of AIS patients in the intensive and standard atorvastatin treatment groups before and after propensity score matching. The baseline characteristics of the intensive and standard atorvastatin treatment groups, both before and after propensity score matching (PSM), are summarized in Table 1 . Before matching, significant differences were observed in multiple demographic, clinical, and laboratory parameters. Following 1:1 PSM, 2,032 patients (1,016 pairs) were successfully matched, and all baseline characteristics were well-balanced between the two groups (All P > 0.05), confirming the effectiveness of the matching process. As detailed in Table 1 , prior to PSM, patients in the intensive atorvastatin group were younger, had a higher proportion of males, smokers, and drinkers, and exhibited a different comorbidity and intervention profile compared to the standard-dose group. These pre-existing imbalances were effectively mitigated after PSM, creating comparable groups for a robust evaluation of the treatment effect on the outcomes of interest. Table 1 Baseline characteristics of AIS patients in the intensive and standard atorvastatin treatment groups before and after propensity score matching Variable Before PSM After PSM Intensive treatment (n = 2057) Standard treatment (n = 1042) P Value Intensive treatment (n = 1016) Standard treatment (n = 1016) P Value Age, years, Median (IQR) 67(58,75) 70(60,79) < 0.001 69(60,70) 70(59,78) 0.217 Male, n (%) 1453(67.4) 648(62.2) 0.004 655(64.5) 637(62.7) 0.407 Smoking History, n (%) 968(44.9) 351(33.7) < 0.001 384(37.8) 351(34.5) 0.128 Alcohol History, n (%) 776(36.0) 334(32.1) 0.029 334(32.9) 331(32.6) 0.887 Medical History, n (%) Hypertension 1345(62.4) 697(66.9) 0.012 660(65.0) 677(66.6) 0.427 Diabetes Mellitus 577(26.8) 257(24.7) 0.208 272(26.8) 249(24.5) 0.243 Atrial Fibrillation 94(4.4) 98(9.4) < 0.001 76(7.5) 76(7.5) 1.000 Coronary Heart Disease 45(2.1) 35(3.4) 0.031 30(3.0) 32(3.1) 0.796 COPD 13(0.6) 7(0.7) 0.816 8(0.8) 6(0.6) 0.592 Clinical Features, n (%) Consciousness Disorder 176(8.2) 121(11.6) 0.002 107(10.5) 113(11.1) 0.668 Nasogastric Tube 214(9.9) 152(14.6) < 0.001 141(13.9) 139(13.7) 0.898 Tracheal Intubation/Tracheostomy 35(1.6) 29(2.8) 0.028 23(2.3) 25(2.5) 0.770 Dysphagia 241(11.2) 120(11.5) 0.774 119(11.7) 115(11.3) 0.781 Admission NIHSS Score, Median (IQR) 3(1,6) 3(1,7) 0.223 3(1,7) 3(1,7) 0.005 Length of Hospital Stay, days, Median (IQR) 8(7,11) 8(7,11) 0.916 8(7,11) 8(7,11) 0.372 Post-Stroke Pneumonia, n (%) 144(6.7) 99(9.5) 0.005 89(8.8) 84(8.3) 0.691 Stroke Location, n (%) Anterior Circulation 1301(60.3) 631(60.6) < 0.001 650(64.0) 612(60.2) 0.013 Anterior & Posterior Circulation 565(26.2) 320(30.7) 256(25.2) 313(30.8) Posterior Circulation 291(13.5) 91(8.7) 110(10.8) 91(9.0) TOAST Classification, n (%) LAA 1667(77.3) 740(71.0) < 0.001 752(74.0) 731(71.9) 0.585 CE 244(11.3) 180(17.3) 149(14.7) 164(16.1) SVO 161(7.5) 91(8.7) 78(7.7) 90(8.9) ODE 20(0.9) 7(0.7) 6(0.6) 7(0.7) UDE 65(3.0) 24(2.3) 31(3.1) 24(2.4) Laboratory Parameters, Median (IQR) White Blood Cell Count (x10⁹/L) 7.02(5.81,8.52) 7.14(5.79,8.54) 0.597 6.98(5.80,8.43) 7.09(5.78,8.51) 0.521 Lymphocyte Count (x10⁹/L) 1.69(1.33,2.11) 1.6(1.24,2.06) 0.001 1.62(1.28,2.05) 1.61(1.24,2.07) 0.557 Albumin (g/L) 37.9(35.6,40.2) 37.1(35.0,39.8) < 0.001 37.4(35.3,39.9) 37.2(35.1,39.9) 0.430 Total Cholesterol (mmol/L) 4.51(3.75,5.31) 4.40(3.65,5.27) 0.079 4.45(3.73,5.25) 4.42(3.67,5.27) 0.645 Triglycerides (mmol/L) 1.44(1.07,2.00) 1.34(0.99,1.91) 0.003 1.39(1.04,1.97) 1.35(1.00,1.92) 0.330 LDL-C (mmol/L) 2.46(1.90,3.09) 2.33(1.80,2.95) 0.001 2.42(1.86,3.04) 2.35(1.82,2.96) 0.136 HDL-C (mmol/L) 0.99(0.85,1.18) 1.01(0.87,1.21) 0.012 1.00(0.86,1.20) 1.01(0.87,1.21) 0.171 Notes : PSM, Propensity Score Matching; IQR, Interquartile Range; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of Org 10172 in Acute Stroke Treatment; LAA, large-artery atherosclerosis; CE, cardio embolism; SVO, small-vessel occlusion; ODE, stroke of other determined etiology; UDE, stroke of undetermined etiology; LDL-C, Low-Density Lipoprotein Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; COPD, Chronic Obstructive Pulmonary Disease; P values in bold and italic indicate statistical significance at P < 0.05. Logistic regression exploring independent risk factors for post-stroke pneumonia. The results of the univariate and multivariate logistic regression analyses for PSP risk are presented in Tables 2 (before PSM) and 3 (after PSM). In the pre-matched cohort, intensive atorvastatin treatment appeared as a protective factor in univariate analysis (OR = 0.681, 95% CI: 0.522–0.890, P = 0.005). However, after multivariate adjustment for confounders, it was no longer significantly associated with PSP risk (OR = 1.074, 95% CI: 0.756–1.525, P = 0.691). This neutral association was confirmed in the post-matched multivariate analysis (OR = 1.002, 95% CI: 0.672–1.492, P = 0.993). Multivariate models consistently identified several independent risk factors for PSP across both cohorts. The presence of a nasogastric tube, endotracheal intubation/tracheostomy, a higher admission NIHSS score, and a longer hospital stay were significantly associated with an increased risk of PSP. Conversely, a higher lymphocyte count and triglyceride level were identified as consistent protective factors. Table 2 Univariate and multivariate logistic regression analysis for post-stroke pneumonia risk before propensity score matching Variable Univariate Multivariate β P Value OR(95%CI) β P Value OR(95%CI) Intensive Atorvastatin treatment Group -0.384 0.005 0.681(0.522–0.890) 0.071 0.691 1.074(0.756–1.525) Age (years) 0.051 < 0.001 1.053(1.040–1.066) 0.021 0.010 1.021 (1.005–1.038) Smoking History -0.059 0.665 0.943(0.722–1.231) - - - Atrial Fibrillation 1.291 < 0.001 3.635(2.495–5.296) 0.191 0.496 1.210(0.699–2.097) Coronary Heart Disease 0.571 0.098 1.769(0.900-3.478) - - - Consciousness Disorder 2.078 < 0.001 7.992(5.945–10.744) 0.022 0.924 1.022(0.654–1.598) Nasogastric Tube 3.248 < 0.001 25.734(19.054–34.757) 1.441 < 0.001 4.226(2.726–6.552) Tracheal Intubation/Tracheostomy 4.097 < 0.001 60.133(32.148-112.479) 2.111 < 0.001 8.255(3.814–17.867) Dysphagia 1.427 < 0.001 4.168(3.093–5.616) 0.460 0.022 1.583(1.069–2.345) Admission NIHSS Score 0.166 < 0.001 1.180(1.156–1.205) 0.039 0.008 1.039(1.010–1.070) Length of Hospital Stay (days) 0.166 < 0.001 1.181(1.151–1.211) 0.077 < 0.001 1.080(1.048–1.112) Stroke Location Anterior Circulation ref ref ref ref ref ref Anterior & Posterior Circulation 0.613 < 0.001 1.847(1.403–2.431) 0.323 0.082 1.381(0.960–1.986) Posterior Circulation -0.467 0.085 0.627(0.368–1.067) -0.342 0.321 0.710(0.362–1.396) TOAST Classification LAA ref ref ref ref ref ref CE 1.516 < 0.001 4.556(3.417–6.076) 0.248 0.263 1.281 (0.830–1.978) SVO -1.619 0.006 0.198(0.063–0.626) -0.535 0.377 0.586(0.179–1.920) ODE -18.403 0.998 < 0.001 -19.057 0.998 < 0.001 UDE 0.733 0.035 2.081(1.054–4.108) -0.002 0.997 0.998(0.377–2.645) White Blood Cell Count (x10⁹/L) 0.255 < 0.001 1.291(1.234–1.349) 0.136 < 0.001 1.146(1.085–1.211) Lymphocyte Count (x10⁹/L) -1.550 < 0.001 0.212(0.160–0.282) -0.831 < 0.001 0.435(0.310–0.611) Albumin (g/L) -0.127 < 0.001 0.880(0.851–0.911) -0.019 0.371 0.981(0.941–1.023) Triglycerides (mmol/L) -0.993 < 0.001 0.371(0.286–0.480) -0.353 0.017 0.703(0.526–0.939) HDL-C (mmol/L) -0.154 0.546 0.858(0.521–1.411) - - - LDL-C (mmol/L) -0.027 0.721 0.974(0.841–1.127) - - - Notes : PSM, Propensity Score Matching; 95% CI, 95% Confidence Interval; OR, Odds Ratio; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of Org 10172 in Acute Stroke Treatment; LAA, large-artery atherosclerosis; CE, cardio embolism; SVO, small-vessel occlusion; ODE, stroke of other determined etiology; UDE, stroke of undetermined etiology; LDL-C, Low-Density Lipoprotein Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; P values in bold and italic indicate statistical significance at P < 0.05. Table 3 Univariate and multivariate logistic regression analysis for post-stroke pneumonia risk after propensity score matching Variable Univariate Multivariate β P Value OR(95%CI) β P Value OR(95%CI) Intensive Atorvastatin treatment Group -0.063 0.691 0.939(0.687–1.282) 0.002 0.993 1.002(0.672–1.492) Age (years) 0.049 < 0.001 1.051(1.035–1.066) 0.025 0.010 1.025(1.006–1.045) Smoking History 0.012 0.944 1.012(0.732–1.398) - - - Atrial Fibrillation 0.942 < 0.001 2.565(1.638–4.019) 0.019 0.954 1.019(0.538–1.931) Coronary Heart Disease 0.483 0.213 1.621(0.758–3.463) - - - Consciousness Disorder 1.984 < 0.001 7.273(5.139–10.293) -0.120 0.655 0.887(0.523–1.502) Nasogastric Tube 3.249 < 0.001 25.754(17.874–37.106) 1.909 < 0.001 6.744(2.805–16.217) Tracheal Intubation/Tracheostomy 3.952 < 0.001 52.046(25.380-106.730) 1.700 < 0.001 5.472(3.234–9.260) Dysphagia 1.342 < 0.001 3.829(2.669–5.491) 0.350 0.146 1.420(0.885–2.277) Admission NIHSS Score 0.159 < 0.001 1.172(1.144–1.202) 0.034 0.051 1.034(1.000-1.070) Length of Hospital Stay (days) 0.165 < 0.001 1.180(1.145–1.215) 0.081 < 0.001 1.085(1.046–1.124) Stroke Location Anterior Circulation ref ref ref ref ref ref Anterior & Posterior Circulation 0.718 < 0.001 2.050(1.480–2.841) 0.435 0.049 1.545(1.002–2.380) Posterior Circulation -0.246 0.455 0.782(0.410–1.491) -0.233 0.597 0.792(0.335–1.875) TOAST Classification LAA ref ref ref ref ref ref CE 1.407 < 0.001 4.086(2.914–5.728) 0.174 0.501 1.190(0.717–1.977) SVO -1.748 0.015 0.174(0.043–0.713) -0.556 0.457 0.574(0.133–2.480) ODE -18.532 0.999 < 0.001 -18.655 0.998 < 0.001 UDE 0.570 0.200 1,769(0.739–4.234) 0.339 0.589 1.403(0.411–4.791) White Blood Cell Count (x10⁹/L) 0.246 < 0.001 1.279(1.213–1.349) 0.105 0.001 1.111(1.041–1.186) Lymphocyte Count (x10⁹/L) -1.471 < 0.001 0.230(0.164–0.322) -0.667 0.001 0.513(0.345–0.765) Albumin (g/L) -0.111 < 0.001 0.895(0.860–0.932) -0.010 0.680 0.990(0.942–1.040) Triglycerides (mmol/L) -0.966 < 0.001 0.381(0.280–0.518) -0.366 0.041 0.693(0.488–0.985) HDL-C (mmol/L) -0.150 0.610 0.861(0.485–1.530) - - - LDL-C (mmol/L) -0.037 0.682 0.964(0.807–1.151) - - - Note : PSM, propensity score matching; 95% CI, 95% confidence Interval; OR, odds ratio; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of Org 10172 in acute stroke treatment; LAA, large-artery atherosclerosis; CE, cardio embolism; SVO, small-vessel occlusion; ODE, stroke of other determined etiology; UDE, stroke of undetermined etiology. LDL-C, Low-Density Lipoprotein Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; P values in bold and italic indicate statistical significance at P < 0.05. Impact of different atorvastatin doses on post-stroke pneumonia severity and multidrug-resistant organisms The analysis of pneumonia severity and MDRO infection rates among the patients who developed PSP is summarized in Table 4 . Before PSM, among 243 PSP patients, there were no significant differences between the intensive and standard treatment groups in the CURB-65 score distribution (P = 0.089), the proportion of severe pneumonia (P = 0.317), or the rate of MDRO infection (P = 0.637). After PSM, in the balanced cohort of 173 PSP patients, these findings remained consistent. The severity of pneumonia, as measured by CURB-65 scores and severity categories, was comparable between the two groups (P = 0.688 and P = 0.863, respectively). Furthermore, the incidence of MDRO infection was not significantly different (9.5% vs. 10.1%, P = 0.897). Table 4 Severity and multidrug-resistant organism infection in post-stroke pneumonia patients before and after propensity score matching Characteristic Before PSM After PSM PSP patients (n = 243) PSP patients (n = 173) Intensive treatment (n = 144) Standard treatment (n = 99) P Value Intensive treatment (n = 84) Standard treatment (n = 89) P Value CURB-65 Score, Median (IQR) 2(1–2) 2(1–2) 0.089 2(1–2) 2(1–2) 0.688 PSP Severity, n (%) 0.317 0.863 Mild 58(40.3) 31(31.3) 26(31.0) 31(34.8) Moderate 59(41.0) 44(44.4) 40(47.6) 40(44.9) Severe 27(18.8) 24(24.2) 18(21.4) 18(20.2) MDRO Infection (Yes, n (%)) 12(8.3) 10(10.1) 0.637 8(9.5) 9(10.1) 0.897 Note : PSM, propensity score matching; PSP, post-stroke pneumonia; MDRO, multidrug-resistant organism; IQR, interquartile range; P values < 0.05 indicate statistical significance. Discussion This retrospective study of 3,199 patients with Acute Ischemic Stroke (AIS) systematically evaluated the impact of intensive atorvastatin treatment during the acute phase on the risk, severity, and pathogen resistance of Post-Stroke Pneumonia (PSP). Our primary finding is that after effectively balancing baseline characteristics between groups using Propensity Score Matching (PSM), no statistically significant differences were observed between the intensive atorvastatin treatment group and the standard treatment group in the incidence of PSP, pneumonia severity (as measured by the CURB-65 score), or the rate of multidrug-resistant organism (MDRO) infections. Specifically, intensive atorvastatin treatment was not associated with a significantly increased risk of PSP either before or after matching (adjusted OR after matching = 1.002, 95% CI: 0.672–1.492, P = 0.993), nor did it exacerbate pneumonia severity or increase the MDRO infection rate (P > 0.05). This indicates that for AIS patients, intensive lipid-lowering with atorvastatin as part of routine treatment does not increase the risk, severity, or MDRO infection rate of PSP. This finding aligns with the pleiotropic mechanisms of statins, which encompass immunomodulatory, anti-inflammatory, and potential antibacterial effects 8 , 9 , and provides crucial evidence for the safe use of intensive statin treatment in clinical practice. Beyond lipid-lowering, statins possess pleiotropic properties, including anti-inflammatory and immunomodulatory effects 8 , 9 , which theoretically could influence post-stroke infection risk. Preclinical studies have shown that simvastatin can reduce susceptibility to lung bacterial infections in mice by inhibiting splenocyte apoptosis and mitigating post-stroke splenic atrophy, thereby improving the peripheral immunosuppressive state 24 . Atorvastatin has also been demonstrated to modulate gut microbiota, improve gut barrier function, reduce systemic inflammation, and alleviate neuroinflammation 25 . Furthermore, statins exhibit direct antibacterial activity and the ability to inhibit biofilm formation, showing potential effects against resistant bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) 26 – 28 . However, this study did not observe that intensive atorvastatin treatment translated into a significant preventive or aggravating effect on pneumonia in the clinical setting. Several reasons may explain this discrepancy between theory and clinical observation. First, post-stroke immunosuppression is a complex pathophysiological process involving multiple central and peripheral organs (e.g., spleen, thymus, gut), which statins may be insufficient to fully reverse in humans. Second, animal models often employ pre-treatment or specific pathogen challenges, differing significantly from the heterogeneity and complexity of secondary infections following stroke in clinical practice. Our findings are consistent with those of Li et al. 12 , who also found no significant association between statin treatment during the acute phase and PSP risk. Li et al. speculated that their negative result might be related to not distinguishing between statin types and doses. Our study specifically investigated an intensive dose of a particular statin (atorvastatin) and still yielded a neutral conclusion. On the other hand, our results differ from some studies reporting a protective effect of statins. For instance, Scheitz et al. 13 found that continued statin treatment in stroke patients receiving intravenous thrombolysis was associated with a reduced risk of pneumonia, and a Korean cohort study by Song et al. 15 suggested a long-term benefit of statin treatment in preventing PSP. These inconsistencies may be attributed to several factors: differences in study populations (our study excluded patients with a prior stroke history or pre-stroke statin use, focusing on a "statin-naïve" cohort), variations in timing and duration of treatment (our study focused on the acute phase, whereas the effects of long-term secondary prevention statin use might differ), and control for confounding factors. Our PSM and multivariate regression analyses revealed that the intensive treatment group had more favorable baseline characteristics before matching (e.g., younger age, fewer invasive procedures), which might create an illusory "benefit" of statins in some observational studies. After balancing these confounders, statins themselves showed neither a protective effect nor an increased pneumonia risk. Basic research suggests that the immunomodulatory effects of statins may be dose-dependent. van der Meij et al. 29 observed a dose-dependent inhibition of the inflammatory cytokines IL-6 and MCP-1 in the vascular wall of patients with abdominal aortic aneurysm treated with statins. A study on sepsis patients by Ou et al. 16 also indicated that high-intensity statins were more effective than low-intensity statins in improving outcomes. Some evidence further suggests that high-dose statins might be more beneficial for preventing PSP 15 . However, our study did not observe an advantage of intensive-dose atorvastatin regarding PSP, suggesting that during the specific time window of the acute stroke phase, the dysregulated immune system might not be sufficiently modulated by merely increasing the statin dose to initiate or amplify its protective immunomodulatory pathways. Multivariate regression analysis in our study identified independent risk factors for PSP, including nasogastric tube placement, endotracheal intubation/tracheostomy, and dysphagia. These factors are directly related to aspiration risk, which is a core mechanism of PSP. Concurrently, a lower lymphocyte count was also confirmed as an independent risk factor, directly supporting the "stroke-induced immunodepression" theory 7 , 30 , 31 , wherein lymphocyte reduction and dysfunction are key to patient susceptibility to infections. The fact that intensive atorvastatin treatment did not significantly alter the risk associated with these core factors further underscores its limited role in the pathology of PSP and confirms that it does not increase pneumonia severity or MDRO risk. Microbiologically, PSP is predominantly caused by Gram-negative bacteria, commonly Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, with a high rate of MDRO infections 32 , 33 . Although statins demonstrate inhibitory effects against various bacteria (including MRSA, VRE) in vitro and in animal models 26 – 28 , and can reduce bacterial virulence and enhance host clearance capacity 27 , 34 – 36 , the lack of significant difference in MDRO infection rates between the intensive and standard treatment groups in our study suggests that the antibacterial potential of statins may be limited in clinical practice or requires validation in specific populations or against particular pathogens. This study has several limitations. First, as a single-center, retrospective study, although PSM was employed to minimize confounding, residual bias from unknown or unmeasured confounders may persist. Second, the duration of atorvastatin treatment was not analyzed in detail, precluding exploration of the potential effects of long-term maintenance treatment. Third, the lack of dynamic monitoring data on patients' immune function (e.g., lymphocyte subsets, inflammatory cytokines) limits a deeper mechanistic interpretation of the neutral findings. Finally, this study focused solely on atorvastatin; thus, the conclusions may not be directly generalizable to other statins. Based on rigorous control for confounding factors, this study found that intensive atorvastatin treatment does not increase the incidence, severity, or MDRO infection rate of Post-Stroke Pneumonia. Therefore, concerns about infection risk should not deter the use of intensive statin treatment in patients with Acute Ischemic Stroke. Clinical decisions should continue to be guided by the robust evidence for statins in lipid-lowering and cardiovascular secondary prevention 37 , 38 . Prevention and control of PSP should place greater emphasis on comprehensive management strategies, including early identification of high-risk patients, enhanced respiratory care, improved nutritional support, and the implementation of early rehabilitation interventions. Future research should focus on more precise immunomodulatory strategies, such as identifying high-risk populations for post-stroke immunosuppression or exploring combination therapies with statins and other immunomodulators. Concurrently, prospective, multicenter, randomized controlled trials incorporating dynamic monitoring of immune function biomarkers are essential to definitively elucidate the true role of statins in the immunomodulation of post-stroke infections. Conclusion The findings of this study demonstrate that intensive atorvastatin treatment during the acute phase in patients with acute ischemic stroke does not significantly increase the risk, severity, or multidrug-resistant infection rate of post-stroke pneumonia. This finding provides crucial evidence for the safe application of intensive atorvastatin treatment in clinical practice. Based on our results, clinicians managing patients with acute ischemic stroke need not avoid intensive lipid-lowering regimens with atorvastatin due to concerns about infection risk. Instead, they should continue to adhere to guideline recommendations, maintaining statin treatment as a cornerstone of secondary stroke prevention. Furthermore, this study confirmed independent risk factors for post-stroke pneumonia, including nasogastric tube placement, endotracheal intubation/tracheostomy, dysphagia, and a lower lymphocyte count. This underscores that the prevention and management of post-stroke pneumonia should place greater emphasis on comprehensive strategies targeting these modifiable factors. Abbreviations PSM Propensity Score Matching PSP Post-Stroke Pneumonia MDRO Multidrug-Resistant Organism IQR Interquartile Range 95% CI 95% Confidence Interval OR Odds Ratio NIHSS National Institutes of Health Stroke Scale TOAST Trial of Org 10172 in Acute Stroke Treatment LAA Large-Artery Atherosclerosis CE Cardioembolism SVO Small-Vessel Occlusion ODE Stroke of Other Determined Etiology UDE Stroke of Undetermined Etiology LDL-C Low-Density Lipoprotein Cholesterol HDL-C High-Density Lipoprotein Cholesterol COPD Chronic Obstructive Pulmonary Disease Declarations Ethics approval and consent to participate The study protocol was approved by the Research Ethics Board of the First Affiliated Hospital of Wenzhou Medical University. Due to the retrospective, non-interventional and anonymous nature of this study, informed consent from patients was waived. Consent for publication All authors contributed to the article and approved the submitted version. Competing interests The authors report no conflicts of interest in this work. Funding Work was supported by the Public Welfare Science and Technology Plan Project of Wenzhou City (Y20220819, Y2023849) Author Contribution Zhijun Wen: Writing – review & editing, Writing – original draft, Methodology, Formal analysis, Conceptualization. Zhenming Yang: Data curation and Investigation. Jianhua Cheng and Yirui Huang: Writing review, editing, resources, conceptualization and supervision. Acknowledgement We express our gratitude to all the patients in our study. Data Availability The datasets analyzed during the current study are available from the corresponding author upon reasonable request. References Bustamante A, Giralt D, García-Berrocoso T, et al. The impact of post-stroke complications on in-hospital mortality depends on stroke severity. Eur Stroke J. Mar 2017;2(1):54–63. doi: 10.1177/2396987316681872 Suda S, Aoki J, Shimoyama T, et al. Stroke-associated infection independently predicts 3-month poor functional outcome and mortality. J Neurol. Feb 2018;265(2):370–375. doi: 10.1007/s00415-017-8714-6 Westendorp WF, Nederkoorn PJ, Vermeij JD, Dijkgraaf MG, van de Beek D. Post-stroke infection: a systematic review and meta-analysis. BMC Neurol. Sep 20 2011;11:110. doi: 10.1186/1471-2377-11-110 Koennecke HC, Belz W, Berfelde D, et al. Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit. Neurology. Sep 6 2011;77(10):965 – 72. doi: 10.1212/WNL.0b013e31822dc795 Badve MS, Zhou Z, Anderson CS, Hackett ML. Effectiveness and Safety of Antibiotics for Preventing Pneumonia and Improving Outcome after Acute Stroke: Systematic Review and Meta-analysis. J Stroke Cerebrovasc Dis. Nov 2018;27(11):3137–3147. doi: 10.1016/j.jstrokecerebrovasdis.2018.07.001 Maier IL, Becker JC, Leyhe JR, et al. Influence of beta-blocker therapy on the risk of infections and death in patients at high risk for stroke induced immunodepression. PLoS One. 2018;13(4):e0196174. doi: 10.1371/journal.pone.0196174 Faura J, Bustamante A, Miró-Mur F, Montaner J. Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections. J Neuroinflammation. Jun 6 2021;18(1):127. doi: 10.1186/s12974-021-02177-0 Parihar SP, Guler R, Brombacher F. Statins: a viable candidate for host-directed therapy against infectious diseases. Nat Rev Immunol. Feb 2019;19(2):104–117. doi: 10.1038/s41577-018-0094-3 Niedzielski M, Broncel M, Gorzelak-Pabiś P, Woźniak E. New possible pharmacological targets for statins and ezetimibe. Biomed Pharmacother. Sep 2020;129:110388. doi: 10.1016/j.biopha.2020.110388 Becker K, Tanzi P, Kalil A, Shibata D, Cain K. Early statin use is associated with increased risk of infection after stroke. J Stroke Cerebrovasc Dis. Jan 2013;22(1):66–71. doi: 10.1016/j.jstrokecerebrovasdis.2011.06.008 Rodríguez de Antonio LA, Martínez-Sánchez P, Martínez-Martínez MM, et al. Previous statins treatment and risk of post-stroke infections. Neurologia. Apr 2011;26(3):150–6. doi: 10.1016/j.nrl.2010.07.030 Li C, Ma M, Dong S, et al. Statin Treatment in the Acute Phase and the Risk of Post-stroke Pneumonia: A Retrospective Cohort Study. Front Neurol. 2021;12:635079. doi: 10.3389/fneur.2021.635079 Scheitz JF, Endres M, Heuschmann PU, Audebert HJ, Nolte CH. Reduced risk of poststroke pneumonia in thrombolyzed stroke patients with continued statin treatment. Int J Stroke. Jan 2015;10(1):61–6. doi: 10.1111/j.1747-4949.2012.00864.x Weeks DL, Greer CL, Willson MN. Statin Medication Use and Nosocomial Infection Risk in the Acute Phase of Stroke. J Stroke Cerebrovasc Dis. Oct 2016;25(10):2360–7. doi: 10.1016/j.jstrokecerebrovasdis.2016.05.033 Song TJ, Kim J. Effect of Statins on the Risk of Poststroke Pneumonia: National Population-Based Cohort Study. Infect Drug Resist. 2020;13:2689–2698. doi: 10.2147/idr.S258420 Ou SY, Chu H, Chao PW, et al. Effect of the use of low and high potency statins and sepsis outcomes. Intensive Care Med. Oct 2014;40(10):1509–17. doi: 10.1007/s00134-014-3418-1 Jiang L, Wang Y, Gao Y, et al. Age and effect of intensive statin in acute mild ischemic stroke or transient ischemic attack: Subgroup analysis of the INSPIRES trial. J Clin Lipidol. Jul-Aug 2025;19(4):802–811. doi: 10.1016/j.jacl.2025.05.016 Neurology CSo, Society CS. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2023. Chinese Journal of Neurology. 2024;57(06):523–559. doi: 10.3760/cma.j.cn113694-20240410-00221 Costa FM, Lobo K, Lalor Tavares JL, da Silva Gomes RP, Santos L, Oliveira RCS. Intensive versus non-intensive statin therapy in patients with ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci. Aug 2025;138:111361. doi: 10.1016/j.jocn.2025.111361 Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. Jul 1 2014;63(25 Pt B):2889 – 934. doi: 10.1016/j.jacc.2013.11.002 Association EMBoCS, Association SGoEMBoCM, Society EMBoCG, Education KLoEaTRoMo. Chinese Expert Consensus on the Diagnosis and Treatment of Stroke-Associated Pneumonia (2019 Update). Chinese Journal of Emergency Medicine. 2019;28(12):1476–1484. doi: 10.3969/j.issn.1002-1949.2019.12.002 Diseases CSoR. Chinese Guidelines for the Diagnosis and Treatment of Community-Acquired Pneumonia in Adults (2016 Edition). Chinese Journal of Tuberculosis and Respiratory Diseases. 2016;39(04):253–279. doi: 10.3760/cma.j.issn.1001-0939.2016.04.005 Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. Mar 2012;18(3):268–81. doi: 10.1111/j.1469-0691.2011.03570.x Jin R, Zhu X, Liu L, Nanda A, Granger DN, Li G. Simvastatin attenuates stroke-induced splenic atrophy and lung susceptibility to spontaneous bacterial infection in mice. Stroke. Apr 2013;44(4):1135–43. doi: 10.1161/strokeaha.111.000633 Zhang P, Zhang X, Huang Y, et al. Atorvastatin alleviates microglia-mediated neuroinflammation via modulating the microbial composition and the intestinal barrier function in ischemic stroke mice. Free Radic Biol Med. Jan 2021;162:104–117. doi: 10.1016/j.freeradbiomed.2020.11.032 Graziano TS, Cuzzullin MC, Franco GC, et al. Statins and Antimicrobial Effects: Simvastatin as a Potential Drug against Staphylococcus aureus Biofilm. PLoS One. 2015;10(5):e0128098. doi: 10.1371/journal.pone.0128098 Hennessy E, Adams C, Reen FJ, O'Gara F. Is There Potential for Repurposing Statins as Novel Antimicrobials? Antimicrob Agents Chemother. Sep 2016;60(9):5111–21. doi: 10.1128/aac.00192-16 Thangamani S, Mohammad H, Abushahba MF, et al. Exploring simvastatin, an antihyperlipidemic drug, as a potential topical antibacterial agent. Sci Rep. Nov 10 2015;5:16407. doi: 10.1038/srep16407 van der Meij E, Koning GG, Vriens PW, et al. A clinical evaluation of statin pleiotropy: statins selectively and dose-dependently reduce vascular inflammation. PLoS One. 2013;8(1):e53882. doi: 10.1371/journal.pone.0053882 Offner H, Subramanian S, Parker SM, Afentoulis ME, Vandenbark AA, Hurn PD. Experimental stroke induces massive, rapid activation of the peripheral immune system. J Cereb Blood Flow Metab. May 2006;26(5):654–65. doi: 10.1038/sj.jcbfm.9600217 Offner H, Subramanian S, Parker SM, et al. Splenic atrophy in experimental stroke is accompanied by increased regulatory T cells and circulating macrophages. J Immunol. Jun 1 2006;176(11):6523–31. doi: 10.4049/jimmunol.176.11.6523 Xu Q, Zhuang H, Xie Y. Study on the related risk factors and targeted nursing effects in multi-drug resistant bacteria infections in elderly patients with stroke-associated pneumonia. Am J Transl Res. 2021;13(8):9860–9865. Xu J, Yang Z. Risk factors and pathogenic microorganism characteristics for pneumonia in convalescent patients with stroke: A retrospective study of 380 patients from a rehabilitation hospital. J Stroke Cerebrovasc Dis. Aug 2020;29(8):104955. doi: 10.1016/j.jstrokecerebrovasdis.2020.104955 Wang CC, Yang PW, Yang SF, Hsieh KP, Tseng SP, Lin YC. Topical simvastatin promotes healing of Staphylococcus aureus-contaminated cutaneous wounds. Int Wound J. Dec 2016;13(6):1150–1157. doi: 10.1111/iwj.12431 Goldstein JL, Brown MS. Regulation of the mevalonate pathway. Nature. Feb 1 1990;343(6257):425–30. doi: 10.1038/343425a0 Skerry C, Pinn ML, Bruiners N, Pine R, Gennaro ML, Karakousis PC. Simvastatin increases the in vivo activity of the first-line tuberculosis regimen. J Antimicrob Chemother. Sep 2014;69(9):2453–7. doi: 10.1093/jac/dku166 Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. Jul 2021;52(7):e364-e467. doi: 10.1161/str.0000000000000375 Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. Dec 2019;50(12):e344-e418. doi: 10.1161/str.0000000000000211 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8842936","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":611018756,"identity":"f21c9090-629a-4897-8b70-29913b3c97f9","order_by":0,"name":"Zhijun Wen","email":"","orcid":"","institution":"The First Affiliated Hospital of Wenzhou Medical Universit","correspondingAuthor":false,"prefix":"","firstName":"Zhijun","middleName":"","lastName":"Wen","suffix":""},{"id":611018757,"identity":"dfd8af48-0f57-4e2e-974a-599c99d7b5fb","order_by":1,"name":"Zhenming Yang","email":"","orcid":"","institution":"The First Affiliated Hospital of Wenzhou Medical Universit","correspondingAuthor":false,"prefix":"","firstName":"Zhenming","middleName":"","lastName":"Yang","suffix":""},{"id":611018758,"identity":"53709d17-3842-4e72-a1b7-c764f61f90e5","order_by":2,"name":"Jianhua Cheng","email":"","orcid":"","institution":"The First Affiliated Hospital of Wenzhou Medical Universit","correspondingAuthor":false,"prefix":"","firstName":"Jianhua","middleName":"","lastName":"Cheng","suffix":""},{"id":611018759,"identity":"60b71e0d-e559-4ed0-aae7-911802eccfae","order_by":3,"name":"Yirui Huang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwElEQVRIiWNgGAWjYNACg/88jO2NjQ8/EK+lglmGuedws7EE8VrOMNuwz0hvE+AhRjG/2OnEB4xtbDy8Mx+2MUgw2MnpNhDQIjk7d7MBYxsPj+TsxLYHBQzJxmYHCGgxuJ27TYKxTYLHcHZiu4EEw4HEbURqMeCxv3kQqJFoLQxnEngYZzASqQXsF4aKAzyMPYnAQDYgwi/80rkbHzAYHLBnbD/+8OGHCjs5glpAgPkPwp1EKB8Fo2AUjIJRQBgAAM6dPyT6thEkAAAAAElFTkSuQmCC","orcid":"","institution":"Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine","correspondingAuthor":true,"prefix":"","firstName":"Yirui","middleName":"","lastName":"Huang","suffix":""}],"badges":[],"createdAt":"2026-02-10 15:56:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8842936/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8842936/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105352173,"identity":"b45e4fd5-3b21-4efd-823b-0dc690ce2183","added_by":"auto","created_at":"2026-03-25 06:04:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":124009,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of Study Participant Enrollment.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8842936/v1/a36757dce6ae3cf6fd0cf85a.png"},{"id":108199826,"identity":"6f9aa78a-df4b-441a-beb2-4e689be5ce76","added_by":"auto","created_at":"2026-04-30 11:40:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":776142,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8842936/v1/19ebe599-fd44-4f29-ad27-627a4e5f931b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Intensive Versus Standard Statin Therapy in Acute Ischemic Stroke: A Comparative Study on the Risk of Pneumonia and Multidrug-Resistant Bacterial Infections","fulltext":[{"header":"Introduction","content":"\u003cp\u003eStroke as the leading cause of death in China, is often complicated by post-stroke infections, particularly post-stroke pneumonia (PSP) \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e, which can lead to clinical deterioration and increased mortality\u003csup\u003e\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. PSP not only significantly prolongs hospital stays but also elevates the risk of patient death. The prevention and management of PSP have become crucial for improving stroke outcomes. Current clinical attempts, such as prophylactic antibiotic therapy\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e and β-blocker intervention\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e, have failed to effectively reduce the incidence of PSP. Based on the \"stroke-induced immunodepression\" theory, immunomodulation may emerge as a novel preventive and therapeutic direction\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eStatins are cornerstone drugs in the early treatment of acute ischemic stroke. Beyond their lipid-lowering effects, statins possess anti-inflammatory, immunomodulatory, antioxidant, and endothelial-stabilizing properties\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. However, the relationship between these pleiotropic effects and the risk of post-stroke pneumonia remains controversial. Existing research findings can be broadly categorized into three groups: (1) Increased risk of PSP\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e: Becker et al. found that early statin use (within 3 days) after ischemic stroke might be associated with an increased risk of infection within the subsequent 15 days (OR\u0026thinsp;=\u0026thinsp;7.21). (2) No effect on PSP\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e: Rodr\u0026iacute;guez et al. found that prior statin use did not seem to affect the frequency of in-hospital infections in ischemic stroke patients, and Li et al. found no additional benefit in reducing PSP for AIS patients using statins in the acute phase compared to non-users. (3) Reduced risk of PSP\u003csup\u003e\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e: Scheitz et al. found that continued statin use (compared to non-use) in patients with acute ischemic stroke receiving thrombolytic therapy might be associated with a reduced risk of PSP, although its impact on long-term functional outcomes and mortality was not significant. In-depth analysis suggests that differences in the type and dosage of statins used may be key underlying factors contributing to these inconsistent conclusions. For instance, a study on the impact of different statin doses on sepsis outcomes found that the beneficial effect of pre-administrated statins on sepsis outcomes significantly increased with higher doses\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Another study found that statin therapy in the acute phase of ischemic stroke did not appear to increase the risk or severity of PSP. The authors of that study further suggested that the lack of consideration for specific statin types and dosages might explain this finding\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eCurrent guidelines for the early treatment of acute ischemic stroke recommend routine intensive statin therapy for lipid lowering\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. However, against the backdrop of the increasing adoption of intensive statin therapy, and given the pleiotropic effects of statins in acute ischemic stroke along with the aforementioned research controversies, the specific impact of particular dosages (especially intensive doses) on PSP risk remains inadequately studied. Previous research has primarily compared statin use versus non-use regarding PSP risk. Furthermore, there is a lack of systematic investigation into whether intensive statin therapy in the acute phase affects the etiological distribution of PSP or the prevalence of drug-resistant bacteria. This study aims to investigate the effects of different doses of atorvastatin on post-stroke pneumonia, thereby providing relevant evidence for clinical treatment strategies.\u003c/p\u003e"},{"header":"Material and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population\u003c/h2\u003e \u003cp\u003eWe retrospectively collected clinical data of patients with Acute Ischemic Stroke (AIS) admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022 from the electronic medical record system. Patients who met the following inclusion criteria were enrolled: (1) Diagnosis of AIS according to the criteria established by the Chinese Society of Neurology\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e; (2) Age\u0026thinsp;\u0026ge;\u0026thinsp;18 years; (3) Time from onset to admission\u0026thinsp;\u0026le;\u0026thinsp;3 days. The exclusion criteria were as follows: (1) History of prior stroke or transient ischemic attack (TIA); (2) Prophylactic antibiotic treatment administered pre-stroke or during the stroke hospitalization; (3) Pre-existing infectious, autoimmune diseases, or any malignancies; (4) Pre-stroke statin medication use; (5) Pregnancy; (6) Infections during the stroke hospitalization other than PSP; (7) Severe hepatic or renal dysfunction; (8) Incomplete clinical data.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e This study was approved by the Ethics Committee of the First Affiliated Hospital of Wenzhou Medical University and was conducted in accordance with the principles of the Declaration of Helsinki. As a retrospective observational study that met the following conditions: (1) all data were derived from de-identified archival information from the hospital's electronic medical record system; (2) the research process involved no additional interventions; (3) data analysis was performed on a fully anonymized dataset (with sensitive information such as names and ID numbers removed); and (4) the study results would not disclose individual patient treatment details, the Ethics Committee granted a waiver of informed consent in compliance with the Declaration of Helsinki and relevant Chinese regulations (\"Ethical Review Measures for Biomedical Research Involving Humans\"). The entire study adhered to the \"Management Specifications for Privacy and Data Sharing in Medical Research (2021 Edition).\"\u003c/p\u003e\n\u003ch3\u003eMethods\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Collection\u003c/h2\u003e \u003cp\u003eBaseline characteristics were collected from electronic medical records, including:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eDemographic parameters: Age and gender.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eClinical characteristics: Systolic blood pressure, diastolic blood pressure, respiratory rate, presence of nasogastric tube, endotracheal intubation or tracheostomy, dysphagia, admission NIHSS score, and length of hospital stay.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eMedical history: Smoking history, alcohol consumption history, hypertension, diabetes mellitus, coronary heart disease, atrial fibrillation, and chronic obstructive pulmonary disease (COPD).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eLaboratory parameters: White blood cell count, lymphocyte count, serum albumin level, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and blood Urea nitrogen.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eImaging characteristics: TOAST ((Trial of ORG 10172 in Acute Stroke Treatment). classification and stroke location (anterior circulation, combined anterior/posterior circulation, and posterior circulation).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDefinition of Intensive Atorvastatin treatment\u003c/h3\u003e\n\u003cp\u003eBased on a previous study\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003eand the American Heart Association's definition for intensive atorvastatin treatment\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e, intensive treatment in this study was defined as the administration of atorvastatin at a dose\u0026thinsp;\u0026ge;\u0026thinsp;40 mg/d, initiated within 72 hours of symptom onset (acute phase). The standard treatment was defined as 20 mg/d.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDiagnostic Criteria for Post-Stroke Pneumonia\u003c/b\u003e \u003csup\u003e \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e \u003c/sup\u003e \u003c/p\u003e \u003cp\u003ePSP was diagnosed based on the presence of new or progressive infiltrative changes on chest imaging after stroke onset, plus at least two of the following clinical symptoms/signs:\u003c/p\u003e \u003cp\u003e(1) New or worsened cough/sputum production, with or without chest pain;\u003c/p\u003e \u003cp\u003e(2) Signs of pulmonary consolidation and/or moist rales;\u003c/p\u003e \u003cp\u003e(3) Fever (body temperature\u0026thinsp;\u0026ge;\u0026thinsp;38\u0026deg;C);\u003c/p\u003e \u003cp\u003e(4) White blood cell count\u0026thinsp;\u0026ge;\u0026thinsp;10\u0026times;10⁹/L or \u0026le;\u0026thinsp;4\u0026times;10⁹/L, with or without a left shift.\u003c/p\u003e \u003cp\u003eConditions with similar clinical presentations, such as lung cancer, pulmonary tuberculosis, pulmonary edema, atelectasis, non-infectious interstitial lung disease, and pulmonary embolism, were rigorously excluded.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSeverity of Post-Stroke Pneumonia\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e\u003c/h2\u003e \u003cp\u003eThe severity of PSP was assessed using the CURB-65 score during hospitalization. A CURB-65 score\u0026thinsp;\u0026ge;\u0026thinsp;3 was defined as severe pneumonia. The CURB-65 score is calculated as follows (1 point for each):\u003c/p\u003e \u003cp\u003e(1) Confusion;\u003c/p\u003e \u003cp\u003e(2) Blood Urea nitrogen\u0026thinsp;\u0026gt;\u0026thinsp;7 mmol/L;\u003c/p\u003e \u003cp\u003e(3) Respiratory rate\u0026thinsp;\u0026ge;\u0026thinsp;30 breaths/min;\u003c/p\u003e \u003cp\u003e(4) Systolic blood pressure\u0026thinsp;\u0026lt;\u0026thinsp;90 mmHg or Diastolic blood pressure\u0026thinsp;\u0026le;\u0026thinsp;60 mmHg;\u003c/p\u003e \u003cp\u003e(5) Age\u0026thinsp;\u0026ge;\u0026thinsp;65 years.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDefinition of Multidrug-Resistant Organisms\u003c/h3\u003e\n\u003cp\u003eAccording to a currently internationally authoritative and widely cited definitive publication\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e, multidrug-resistant organisms (MDROs) in this study were defined as bacteria acquiring resistance to three or more classes of antimicrobial agents listed in the antimicrobial spectrum classification.\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis and graphing were performed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp, Armonk, NY, USA). The Kolmogorov-Smirnov test was used to assess the normality of continuous variables. Normally distributed continuous variables were compared using Student's t-test and one-way ANOVA, expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. For non-normally distributed continuous variables, the Mann-Whitney U test was used to assess differences between two groups, expressed as median (interquartile range). Categorical variables were analyzed using the Chi-square test or Fisher's exact test, expressed as number (n) and percentage (%). Spearman correlation analysis was used to explore the correlation between two non-normally distributed variables. The significance level was set at a two-tailed p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Logistic regression analysis was used to analyze the relationship between the occurrence of post-stroke pneumonia and intensive atorvastatin treatment during the acute phase. Multivariable logistic regression analysis included all variables with p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in univariable logistic regression and covariates previously associated with PSP in the literature. The logistic regression models were analyzed before and after propensity matching, respectively. All tests were two-sided, and p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePropensity Score Matching (PSM)\u003c/h2\u003e \u003cp\u003eThe propensity score was obtained using logistic regression, with intensive atorvastatin treatment during the acute phase as the dependent variable. Nearest neighbor matching was performed for 1:1 matching without replacement, matching patients in the intensive atorvastatin treatment group with those in the standard atorvastatin treatment group using a caliper width of 0.02. Variables used in the propensity matching process were: Age, gender, smoking history, alcohol history, history of hypertension, history of atrial fibrillation, history of coronary heart disease, consciousness disorder, presence of nasogastric tube, tracheal intubation/tracheostomy, stroke location, TOAST classification, lymphocyte count, albumin, triglycerides, LDL-C, HDL-C.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eBaseline Characteristics\u003c/h2\u003e \u003cp\u003eDuring the study period, a total of 4843 patients with acute ischemic stroke who were admitted to and treated in the Department of Neurology at the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022 were initially identified (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). After applying the inclusion and exclusion criteria, 3199 patients were ultimately included in the analysis. In all patients, 2101 were males (65.7%), with a mean age of 68.00 (58.00,76.00) years. A total of 2157 (67.4%) patients received intensive atorvastatin treatment in the acute phase, and 1042 (32.6%) patients received standard atorvastatin treatment in the acute phase. Among the included cohort of 3199 patients, 243 (7.6%) patients developed pneumonia after acute ischemic stroke.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eBaseline characteristics of AIS patients in the intensive and standard atorvastatin treatment groups before and after propensity score matching.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe baseline characteristics of the intensive and standard atorvastatin treatment groups, both before and after propensity score matching (PSM), are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Before matching, significant differences were observed in multiple demographic, clinical, and laboratory parameters. Following 1:1 PSM, 2,032 patients (1,016 pairs) were successfully matched, and all baseline characteristics were well-balanced between the two groups (All P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), confirming the effectiveness of the matching process. As detailed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, prior to PSM, patients in the intensive atorvastatin group were younger, had a higher proportion of males, smokers, and drinkers, and exhibited a different comorbidity and intervention profile compared to the standard-dose group. These pre-existing imbalances were effectively mitigated after PSM, creating comparable groups for a robust evaluation of the treatment effect on the outcomes of interest.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of AIS patients in the intensive and standard atorvastatin treatment groups before and after propensity score matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eBefore PSM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eAfter PSM\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntensive treatment (n\u0026thinsp;=\u0026thinsp;2057)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandard treatment (n\u0026thinsp;=\u0026thinsp;1042)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIntensive treatment (n\u0026thinsp;=\u0026thinsp;1016)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStandard treatment (n\u0026thinsp;=\u0026thinsp;1016)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge, years, Median (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67(58,75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(60,79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69(60,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e70(59,78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.217\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1453(67.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e648(62.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e655(64.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e637(62.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.407\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking History, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e968(44.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e351(33.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e384(37.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e351(34.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.128\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol History, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e776(36.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e334(32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e334(32.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e331(32.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.887\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedical History, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1345(62.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e697(66.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e660(65.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e677(66.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.427\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e577(26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e257(24.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e272(26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e249(24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtrial Fibrillation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94(4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98(9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76(7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e76(7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronary Heart Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.796\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOPD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.816\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6(0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eClinical Features, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness Disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e176(8.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121(11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e107(10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e113(11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.668\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNasogastric Tube\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e214(9.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e152(14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e141(13.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e139(13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.898\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTracheal Intubation/Tracheostomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23(2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.770\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDysphagia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e241(11.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120(11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.774\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e119(11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e115(11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.781\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdmission NIHSS Score, Median (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(1,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(1,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(1,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3(1,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength of Hospital Stay, days, Median (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(7,11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(7,11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.916\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8(7,11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8(7,11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.372\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePost-Stroke Pneumonia, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e144(6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99(9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e89(8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e84(8.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStroke Location, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1301(60.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e631(60.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e650(64.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e612(60.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.013\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnterior \u0026amp; Posterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e565(26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e320(30.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e256(25.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e313(30.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePosterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e291(13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e110(10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e91(9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTOAST Classification, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1667(77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e740(71.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e752(74.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e731(71.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.585\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e244(11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e180(17.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e149(14.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e164(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSVO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e161(7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78(7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e90(8.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eODE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6(0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUDE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24(2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLaboratory Parameters, Median (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite Blood Cell Count (x10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.02(5.81,8.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.14(5.79,8.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.597\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.98(5.80,8.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.09(5.78,8.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.521\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte Count (x10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.69(1.33,2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.6(1.24,2.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.62(1.28,2.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.61(1.24,2.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.557\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin (g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.9(35.6,40.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.1(35.0,39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.4(35.3,39.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.2(35.1,39.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.430\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Cholesterol (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.51(3.75,5.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.40(3.65,5.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.45(3.73,5.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.42(3.67,5.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.645\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.44(1.07,2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.34(0.99,1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.39(1.04,1.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.35(1.00,1.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.330\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL-C (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.46(1.90,3.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.33(1.80,2.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.42(1.86,3.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.35(1.82,2.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL-C (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.99(0.85,1.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.01(0.87,1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00(0.86,1.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.01(0.87,1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.171\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNotes\u003c/b\u003e: PSM, Propensity Score Matching; IQR, Interquartile Range; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of Org 10172 in Acute Stroke Treatment; LAA, large-artery atherosclerosis; CE, cardio embolism; SVO, small-vessel occlusion; ODE, stroke of other determined etiology; UDE, stroke of undetermined etiology; LDL-C, Low-Density Lipoprotein Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; COPD, Chronic Obstructive Pulmonary Disease; P values in bold and italic indicate statistical significance at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eLogistic regression exploring independent risk factors for post-stroke pneumonia.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe results of the univariate and multivariate logistic regression analyses for PSP risk are presented in Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (before PSM) and 3 (after PSM). In the pre-matched cohort, intensive atorvastatin treatment appeared as a protective factor in univariate analysis (OR\u0026thinsp;=\u0026thinsp;0.681, 95% CI: 0.522\u0026ndash;0.890, P\u0026thinsp;=\u0026thinsp;0.005). However, after multivariate adjustment for confounders, it was no longer significantly associated with PSP risk (OR\u0026thinsp;=\u0026thinsp;1.074, 95% CI: 0.756\u0026ndash;1.525, P\u0026thinsp;=\u0026thinsp;0.691). This neutral association was confirmed in the post-matched multivariate analysis (OR\u0026thinsp;=\u0026thinsp;1.002, 95% CI: 0.672\u0026ndash;1.492, P\u0026thinsp;=\u0026thinsp;0.993).\u003c/p\u003e \u003cp\u003eMultivariate models consistently identified several independent risk factors for PSP across both cohorts. The presence of a nasogastric tube, endotracheal intubation/tracheostomy, a higher admission NIHSS score, and a longer hospital stay were significantly associated with an increased risk of PSP. Conversely, a higher lymphocyte count and triglyceride level were identified as consistent protective factors.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multivariate logistic regression analysis for post-stroke pneumonia risk before propensity score matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eUnivariate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eMultivariate\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive Atorvastatin treatment Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.681(0.522\u0026ndash;0.890)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.074(0.756\u0026ndash;1.525)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.053(1.040\u0026ndash;1.066)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.021 (1.005\u0026ndash;1.038)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking History\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.665\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.943(0.722\u0026ndash;1.231)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtrial Fibrillation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.635(2.495\u0026ndash;5.296)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.210(0.699\u0026ndash;2.097)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronary Heart Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.571\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.769(0.900-3.478)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness Disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.992(5.945\u0026ndash;10.744)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.924\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.022(0.654\u0026ndash;1.598)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNasogastric Tube\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.734(19.054\u0026ndash;34.757)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.441\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.226(2.726\u0026ndash;6.552)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTracheal Intubation/Tracheostomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.133(32.148-112.479)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.255(3.814\u0026ndash;17.867)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDysphagia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.168(3.093\u0026ndash;5.616)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.583(1.069\u0026ndash;2.345)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmission NIHSS Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.180(1.156\u0026ndash;1.205)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.039(1.010\u0026ndash;1.070)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of Hospital Stay (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.181(1.151\u0026ndash;1.211)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.080(1.048\u0026ndash;1.112)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke Location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnterior \u0026amp; Posterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.847(1.403\u0026ndash;2.431)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.381(0.960\u0026ndash;1.986)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePosterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.627(0.368\u0026ndash;1.067)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.321\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.710(0.362\u0026ndash;1.396)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTOAST Classification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.556(3.417\u0026ndash;6.076)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.281 (0.830\u0026ndash;1.978)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSVO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.198(0.063\u0026ndash;0.626)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.586(0.179\u0026ndash;1.920)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eODE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-18.403\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-19.057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUDE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.733\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.035\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.081(1.054\u0026ndash;4.108)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.997\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.998(0.377\u0026ndash;2.645)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite Blood Cell Count (x10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.291(1.234\u0026ndash;1.349)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.146(1.085\u0026ndash;1.211)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte Count (x10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.212(0.160\u0026ndash;0.282)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.435(0.310\u0026ndash;0.611)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin (g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.880(0.851\u0026ndash;0.911)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.981(0.941\u0026ndash;1.023)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.993\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.371(0.286\u0026ndash;0.480)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.703(0.526\u0026ndash;0.939)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL-C (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.858(0.521\u0026ndash;1.411)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL-C (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.721\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.974(0.841\u0026ndash;1.127)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNotes\u003c/b\u003e: PSM, Propensity Score Matching; 95% CI, 95% Confidence Interval; OR, Odds Ratio; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of Org 10172 in Acute Stroke Treatment; LAA, large-artery atherosclerosis; CE, cardio embolism; SVO, small-vessel occlusion; ODE, stroke of other determined etiology; UDE, stroke of undetermined etiology; LDL-C, Low-Density Lipoprotein Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; P values in bold and italic indicate statistical significance at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multivariate logistic regression analysis for post-stroke pneumonia risk after propensity score matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eUnivariate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eMultivariate\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive Atorvastatin treatment Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.939(0.687\u0026ndash;1.282)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.993\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.002(0.672\u0026ndash;1.492)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.051(1.035\u0026ndash;1.066)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.025(1.006\u0026ndash;1.045)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking History\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.012(0.732\u0026ndash;1.398)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtrial Fibrillation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.942\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.565(1.638\u0026ndash;4.019)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.954\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.019(0.538\u0026ndash;1.931)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronary Heart Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.621(0.758\u0026ndash;3.463)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsciousness Disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.984\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.273(5.139\u0026ndash;10.293)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.887(0.523\u0026ndash;1.502)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNasogastric Tube\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.754(17.874\u0026ndash;37.106)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.909\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.744(2.805\u0026ndash;16.217)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTracheal Intubation/Tracheostomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.046(25.380-106.730)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.700\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.472(3.234\u0026ndash;9.260)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDysphagia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.829(2.669\u0026ndash;5.491)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.420(0.885\u0026ndash;2.277)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmission NIHSS Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.172(1.144\u0026ndash;1.202)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.034(1.000-1.070)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of Hospital Stay (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.180(1.145\u0026ndash;1.215)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.085(1.046\u0026ndash;1.124)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke Location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnterior \u0026amp; Posterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.718\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.050(1.480\u0026ndash;2.841)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.049\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.545(1.002\u0026ndash;2.380)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePosterior Circulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.455\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.782(0.410\u0026ndash;1.491)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.597\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.792(0.335\u0026ndash;1.875)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTOAST Classification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eref\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.407\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.086(2.914\u0026ndash;5.728)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.190(0.717\u0026ndash;1.977)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSVO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.748\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.174(0.043\u0026ndash;0.713)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.556\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.457\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.574(0.133\u0026ndash;2.480)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eODE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-18.532\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-18.655\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUDE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.570\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,769(0.739\u0026ndash;4.234)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.589\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.403(0.411\u0026ndash;4.791)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite Blood Cell Count (x10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.279(1.213\u0026ndash;1.349)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.111(1.041\u0026ndash;1.186)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte Count (x10⁹/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.230(0.164\u0026ndash;0.322)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.513(0.345\u0026ndash;0.765)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin (g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.895(0.860\u0026ndash;0.932)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.680\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.990(0.942\u0026ndash;1.040)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriglycerides (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.381(0.280\u0026ndash;0.518)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.366\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.041\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.693(0.488\u0026ndash;0.985)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHDL-C (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.610\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.861(0.485\u0026ndash;1.530)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL-C (mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.682\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.964(0.807\u0026ndash;1.151)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNote\u003c/b\u003e: PSM, propensity score matching; 95% CI, 95% confidence Interval; OR, odds ratio; NIHSS, National Institutes of Health Stroke Scale; TOAST, Trial of Org 10172 in acute stroke treatment; LAA, large-artery atherosclerosis; CE, cardio embolism; SVO, small-vessel occlusion; ODE, stroke of other determined etiology; UDE, stroke of undetermined etiology. LDL-C, Low-Density Lipoprotein Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; P values in bold and italic indicate statistical significance at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eImpact of different atorvastatin doses on post-stroke pneumonia severity and multidrug-resistant organisms\u003c/h2\u003e \u003cp\u003eThe analysis of pneumonia severity and MDRO infection rates among the patients who developed PSP is summarized in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Before PSM, among 243 PSP patients, there were no significant differences between the intensive and standard treatment groups in the CURB-65 score distribution (P\u0026thinsp;=\u0026thinsp;0.089), the proportion of severe pneumonia (P\u0026thinsp;=\u0026thinsp;0.317), or the rate of MDRO infection (P\u0026thinsp;=\u0026thinsp;0.637). After PSM, in the balanced cohort of 173 PSP patients, these findings remained consistent. The severity of pneumonia, as measured by CURB-65 scores and severity categories, was comparable between the two groups (P\u0026thinsp;=\u0026thinsp;0.688 and P\u0026thinsp;=\u0026thinsp;0.863, respectively). Furthermore, the incidence of MDRO infection was not significantly different (9.5% vs. 10.1%, P\u0026thinsp;=\u0026thinsp;0.897).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSeverity and multidrug-resistant organism infection in post-stroke pneumonia patients before and after propensity score matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eBefore PSM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eAfter PSM\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003ePSP patients (n\u0026thinsp;=\u0026thinsp;243)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003ePSP patients (n\u0026thinsp;=\u0026thinsp;173)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntensive treatment (n\u0026thinsp;=\u0026thinsp;144)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandard treatment (n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIntensive treatment (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStandard treatment (n\u0026thinsp;=\u0026thinsp;89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCURB-65 Score, Median (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(1\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(1\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(1\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(1\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.688\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePSP Severity, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.863\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58(40.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31(31.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26(31.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31(34.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59(41.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44(44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40(47.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40(44.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27(18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(24.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18(21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18(20.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMDRO Infection (Yes, n (%))\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12(8.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8(9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9(10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.897\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNote\u003c/b\u003e: PSM, propensity score matching; PSP, post-stroke pneumonia; MDRO, multidrug-resistant organism; IQR, interquartile range; P values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicate statistical significance.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis retrospective study of 3,199 patients with Acute Ischemic Stroke (AIS) systematically evaluated the impact of intensive atorvastatin treatment during the acute phase on the risk, severity, and pathogen resistance of Post-Stroke Pneumonia (PSP). Our primary finding is that after effectively balancing baseline characteristics between groups using Propensity Score Matching (PSM), no statistically significant differences were observed between the intensive atorvastatin treatment group and the standard treatment group in the incidence of PSP, pneumonia severity (as measured by the CURB-65 score), or the rate of multidrug-resistant organism (MDRO) infections. Specifically, intensive atorvastatin treatment was not associated with a significantly increased risk of PSP either before or after matching (adjusted OR after matching\u0026thinsp;=\u0026thinsp;1.002, 95% CI: 0.672\u0026ndash;1.492, P\u0026thinsp;=\u0026thinsp;0.993), nor did it exacerbate pneumonia severity or increase the MDRO infection rate (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). This indicates that for AIS patients, intensive lipid-lowering with atorvastatin as part of routine treatment does not increase the risk, severity, or MDRO infection rate of PSP. This finding aligns with the pleiotropic mechanisms of statins, which encompass immunomodulatory, anti-inflammatory, and potential antibacterial effects\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e, and provides crucial evidence for the safe use of intensive statin treatment in clinical practice.\u003c/p\u003e \u003cp\u003eBeyond lipid-lowering, statins possess pleiotropic properties, including anti-inflammatory and immunomodulatory effects\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e, which theoretically could influence post-stroke infection risk. Preclinical studies have shown that simvastatin can reduce susceptibility to lung bacterial infections in mice by inhibiting splenocyte apoptosis and mitigating post-stroke splenic atrophy, thereby improving the peripheral immunosuppressive state\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Atorvastatin has also been demonstrated to modulate gut microbiota, improve gut barrier function, reduce systemic inflammation, and alleviate neuroinflammation\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Furthermore, statins exhibit direct antibacterial activity and the ability to inhibit biofilm formation, showing potential effects against resistant bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) \u003csup\u003e\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHowever, this study did not observe that intensive atorvastatin treatment translated into a significant preventive or aggravating effect on pneumonia in the clinical setting. Several reasons may explain this discrepancy between theory and clinical observation. First, post-stroke immunosuppression is a complex pathophysiological process involving multiple central and peripheral organs (e.g., spleen, thymus, gut), which statins may be insufficient to fully reverse in humans. Second, animal models often employ pre-treatment or specific pathogen challenges, differing significantly from the heterogeneity and complexity of secondary infections following stroke in clinical practice.\u003c/p\u003e \u003cp\u003eOur findings are consistent with those of Li et al. \u003csup\u003e12\u003c/sup\u003e, who also found no significant association between statin treatment during the acute phase and PSP risk. Li et al. speculated that their negative result might be related to not distinguishing between statin types and doses. Our study specifically investigated an intensive dose of a particular statin (atorvastatin) and still yielded a neutral conclusion.\u003c/p\u003e \u003cp\u003eOn the other hand, our results differ from some studies reporting a protective effect of statins. For instance, Scheitz et al. \u003csup\u003e13\u003c/sup\u003e found that continued statin treatment in stroke patients receiving intravenous thrombolysis was associated with a reduced risk of pneumonia, and a Korean cohort study by Song et al. \u003csup\u003e15\u003c/sup\u003e suggested a long-term benefit of statin treatment in preventing PSP. These inconsistencies may be attributed to several factors: differences in study populations (our study excluded patients with a prior stroke history or pre-stroke statin use, focusing on a \"statin-na\u0026iuml;ve\" cohort), variations in timing and duration of treatment (our study focused on the acute phase, whereas the effects of long-term secondary prevention statin use might differ), and control for confounding factors. Our PSM and multivariate regression analyses revealed that the intensive treatment group had more favorable baseline characteristics before matching (e.g., younger age, fewer invasive procedures), which might create an illusory \"benefit\" of statins in some observational studies. After balancing these confounders, statins themselves showed neither a protective effect nor an increased pneumonia risk.\u003c/p\u003e \u003cp\u003eBasic research suggests that the immunomodulatory effects of statins may be dose-dependent. van der Meij et al. \u003csup\u003e29\u003c/sup\u003e observed a dose-dependent inhibition of the inflammatory cytokines IL-6 and MCP-1 in the vascular wall of patients with abdominal aortic aneurysm treated with statins. A study on sepsis patients by Ou et al. \u003csup\u003e16\u003c/sup\u003e also indicated that high-intensity statins were more effective than low-intensity statins in improving outcomes. Some evidence further suggests that high-dose statins might be more beneficial for preventing PSP\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. However, our study did not observe an advantage of intensive-dose atorvastatin regarding PSP, suggesting that during the specific time window of the acute stroke phase, the dysregulated immune system might not be sufficiently modulated by merely increasing the statin dose to initiate or amplify its protective immunomodulatory pathways.\u003c/p\u003e \u003cp\u003eMultivariate regression analysis in our study identified independent risk factors for PSP, including nasogastric tube placement, endotracheal intubation/tracheostomy, and dysphagia. These factors are directly related to aspiration risk, which is a core mechanism of PSP. Concurrently, a lower lymphocyte count was also confirmed as an independent risk factor, directly supporting the \"stroke-induced immunodepression\" theory\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e, wherein lymphocyte reduction and dysfunction are key to patient susceptibility to infections. The fact that intensive atorvastatin treatment did not significantly alter the risk associated with these core factors further underscores its limited role in the pathology of PSP and confirms that it does not increase pneumonia severity or MDRO risk.\u003c/p\u003e \u003cp\u003eMicrobiologically, PSP is predominantly caused by Gram-negative bacteria, commonly Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, with a high rate of MDRO infections\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e. Although statins demonstrate inhibitory effects against various bacteria (including MRSA, VRE) in vitro and in animal models\u003csup\u003e\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e, and can reduce bacterial virulence and enhance host clearance capacity\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan additionalcitationids=\"CR35\" citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e, the lack of significant difference in MDRO infection rates between the intensive and standard treatment groups in our study suggests that the antibacterial potential of statins may be limited in clinical practice or requires validation in specific populations or against particular pathogens.\u003c/p\u003e \u003cp\u003eThis study has several limitations. First, as a single-center, retrospective study, although PSM was employed to minimize confounding, residual bias from unknown or unmeasured confounders may persist. Second, the duration of atorvastatin treatment was not analyzed in detail, precluding exploration of the potential effects of long-term maintenance treatment. Third, the lack of dynamic monitoring data on patients' immune function (e.g., lymphocyte subsets, inflammatory cytokines) limits a deeper mechanistic interpretation of the neutral findings. Finally, this study focused solely on atorvastatin; thus, the conclusions may not be directly generalizable to other statins.\u003c/p\u003e \u003cp\u003eBased on rigorous control for confounding factors, this study found that intensive atorvastatin treatment does not increase the incidence, severity, or MDRO infection rate of Post-Stroke Pneumonia. Therefore, concerns about infection risk should not deter the use of intensive statin treatment in patients with Acute Ischemic Stroke. Clinical decisions should continue to be guided by the robust evidence for statins in lipid-lowering and cardiovascular secondary prevention\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. Prevention and control of PSP should place greater emphasis on comprehensive management strategies, including early identification of high-risk patients, enhanced respiratory care, improved nutritional support, and the implementation of early rehabilitation interventions.\u003c/p\u003e \u003cp\u003eFuture research should focus on more precise immunomodulatory strategies, such as identifying high-risk populations for post-stroke immunosuppression or exploring combination therapies with statins and other immunomodulators. Concurrently, prospective, multicenter, randomized controlled trials incorporating dynamic monitoring of immune function biomarkers are essential to definitively elucidate the true role of statins in the immunomodulation of post-stroke infections.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of this study demonstrate that intensive atorvastatin treatment during the acute phase in patients with acute ischemic stroke does not significantly increase the risk, severity, or multidrug-resistant infection rate of post-stroke pneumonia. This finding provides crucial evidence for the safe application of intensive atorvastatin treatment in clinical practice. Based on our results, clinicians managing patients with acute ischemic stroke need not avoid intensive lipid-lowering regimens with atorvastatin due to concerns about infection risk. Instead, they should continue to adhere to guideline recommendations, maintaining statin treatment as a cornerstone of secondary stroke prevention.\u003c/p\u003e \u003cp\u003eFurthermore, this study confirmed independent risk factors for post-stroke pneumonia, including nasogastric tube placement, endotracheal intubation/tracheostomy, dysphagia, and a lower lymphocyte count. This underscores that the prevention and management of post-stroke pneumonia should place greater emphasis on comprehensive strategies targeting these modifiable factors.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"524\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePropensity Score Matching\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePSP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePost-Stroke Pneumonia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMDRO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMultidrug-Resistant Organism\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIQR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInterquartile Range\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95% Confidence Interval\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOdds Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNIHSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNational Institutes of Health Stroke Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTOAST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTrial of Org 10172 in Acute Stroke Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLAA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLarge-Artery Atherosclerosis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCardioembolism\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSVO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmall-Vessel Occlusion\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eODE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStroke of Other Determined Etiology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUDE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStroke of Undetermined Etiology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLDL-C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLow-Density Lipoprotein Cholesterol\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHDL-C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigh-Density Lipoprotein Cholesterol\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCOPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eChronic Obstructive Pulmonary Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e The study protocol was approved by the Research Ethics Board of the First Affiliated Hospital of Wenzhou Medical University. Due to the retrospective, non-interventional and anonymous nature of this study, informed consent from patients was waived.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eAll authors contributed to the article and approved the submitted version.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors report no conflicts of interest in this work.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eWork was supported by the Public Welfare Science and Technology Plan Project of Wenzhou City (Y20220819, Y2023849)\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eZhijun Wen: Writing \u0026ndash; review \u0026amp; editing, Writing \u0026ndash; original draft, Methodology, Formal analysis, Conceptualization. Zhenming Yang: Data curation and Investigation. Jianhua Cheng and Yirui Huang: Writing review, editing, resources, conceptualization and supervision.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe express our gratitude to all the patients in our study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBustamante A, Giralt D, Garc\u0026iacute;a-Berrocoso T, et al. The impact of post-stroke complications on in-hospital mortality depends on stroke severity. Eur Stroke J. Mar 2017;2(1):54\u0026ndash;63. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/2396987316681872\u003c/span\u003e\u003cspan address=\"10.1177/2396987316681872\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuda S, Aoki J, Shimoyama T, et al. Stroke-associated infection independently predicts 3-month poor functional outcome and mortality. J Neurol. Feb 2018;265(2):370\u0026ndash;375. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00415-017-8714-6\u003c/span\u003e\u003cspan address=\"10.1007/s00415-017-8714-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWestendorp WF, Nederkoorn PJ, Vermeij JD, Dijkgraaf MG, van de Beek D. Post-stroke infection: a systematic review and meta-analysis. BMC Neurol. Sep 20 2011;11:110. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/1471-2377-11-110\u003c/span\u003e\u003cspan address=\"10.1186/1471-2377-11-110\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoennecke HC, Belz W, Berfelde D, et al. Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit. Neurology. Sep 6 2011;77(10):965\u0026thinsp;\u0026ndash;\u0026thinsp;72. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1212/WNL.0b013e31822dc795\u003c/span\u003e\u003cspan address=\"10.1212/WNL.0b013e31822dc795\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBadve MS, Zhou Z, Anderson CS, Hackett ML. Effectiveness and Safety of Antibiotics for Preventing Pneumonia and Improving Outcome after Acute Stroke: Systematic Review and Meta-analysis. J Stroke Cerebrovasc Dis. Nov 2018;27(11):3137\u0026ndash;3147. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jstrokecerebrovasdis.2018.07.001\u003c/span\u003e\u003cspan address=\"10.1016/j.jstrokecerebrovasdis.2018.07.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaier IL, Becker JC, Leyhe JR, et al. Influence of beta-blocker therapy on the risk of infections and death in patients at high risk for stroke induced immunodepression. PLoS One. 2018;13(4):e0196174. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0196174\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0196174\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFaura J, Bustamante A, Mir\u0026oacute;-Mur F, Montaner J. Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections. J Neuroinflammation. Jun 6 2021;18(1):127. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12974-021-02177-0\u003c/span\u003e\u003cspan address=\"10.1186/s12974-021-02177-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParihar SP, Guler R, Brombacher F. Statins: a viable candidate for host-directed therapy against infectious diseases. Nat Rev Immunol. Feb 2019;19(2):104\u0026ndash;117. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41577-018-0094-3\u003c/span\u003e\u003cspan address=\"10.1038/s41577-018-0094-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNiedzielski M, Broncel M, Gorzelak-Pabiś P, Woźniak E. New possible pharmacological targets for statins and ezetimibe. Biomed Pharmacother. Sep 2020;129:110388. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.biopha.2020.110388\u003c/span\u003e\u003cspan address=\"10.1016/j.biopha.2020.110388\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBecker K, Tanzi P, Kalil A, Shibata D, Cain K. Early statin use is associated with increased risk of infection after stroke. J Stroke Cerebrovasc Dis. Jan 2013;22(1):66\u0026ndash;71. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jstrokecerebrovasdis.2011.06.008\u003c/span\u003e\u003cspan address=\"10.1016/j.jstrokecerebrovasdis.2011.06.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRodr\u0026iacute;guez de Antonio LA, Mart\u0026iacute;nez-S\u0026aacute;nchez P, Mart\u0026iacute;nez-Mart\u0026iacute;nez MM, et al. Previous statins treatment and risk of post-stroke infections. Neurologia. Apr 2011;26(3):150\u0026ndash;6. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.nrl.2010.07.030\u003c/span\u003e\u003cspan address=\"10.1016/j.nrl.2010.07.030\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi C, Ma M, Dong S, et al. Statin Treatment in the Acute Phase and the Risk of Post-stroke Pneumonia: A Retrospective Cohort Study. Front Neurol. 2021;12:635079. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fneur.2021.635079\u003c/span\u003e\u003cspan address=\"10.3389/fneur.2021.635079\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eScheitz JF, Endres M, Heuschmann PU, Audebert HJ, Nolte CH. Reduced risk of poststroke pneumonia in thrombolyzed stroke patients with continued statin treatment. Int J Stroke. Jan 2015;10(1):61\u0026ndash;6. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1747-4949.2012.00864.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1747-4949.2012.00864.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWeeks DL, Greer CL, Willson MN. Statin Medication Use and Nosocomial Infection Risk in the Acute Phase of Stroke. J Stroke Cerebrovasc Dis. Oct 2016;25(10):2360\u0026ndash;7. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jstrokecerebrovasdis.2016.05.033\u003c/span\u003e\u003cspan address=\"10.1016/j.jstrokecerebrovasdis.2016.05.033\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong TJ, Kim J. Effect of Statins on the Risk of Poststroke Pneumonia: National Population-Based Cohort Study. Infect Drug Resist. 2020;13:2689\u0026ndash;2698. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/idr.S258420\u003c/span\u003e\u003cspan address=\"10.2147/idr.S258420\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOu SY, Chu H, Chao PW, et al. Effect of the use of low and high potency statins and sepsis outcomes. Intensive Care Med. Oct 2014;40(10):1509\u0026ndash;17. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00134-014-3418-1\u003c/span\u003e\u003cspan address=\"10.1007/s00134-014-3418-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang L, Wang Y, Gao Y, et al. Age and effect of intensive statin in acute mild ischemic stroke or transient ischemic attack: Subgroup analysis of the INSPIRES trial. J Clin Lipidol. Jul-Aug 2025;19(4):802\u0026ndash;811. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jacl.2025.05.016\u003c/span\u003e\u003cspan address=\"10.1016/j.jacl.2025.05.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNeurology CSo, Society CS. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2023. Chinese Journal of Neurology. 2024;57(06):523\u0026ndash;559. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.cn113694-20240410-00221\u003c/span\u003e\u003cspan address=\"10.3760/cma.j.cn113694-20240410-00221\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCosta FM, Lobo K, Lalor Tavares JL, da Silva Gomes RP, Santos L, Oliveira RCS. Intensive versus non-intensive statin therapy in patients with ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci. Aug 2025;138:111361. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jocn.2025.111361\u003c/span\u003e\u003cspan address=\"10.1016/j.jocn.2025.111361\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. Jul 1 2014;63(25 Pt B):2889\u0026thinsp;\u0026ndash;\u0026thinsp;934. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jacc.2013.11.002\u003c/span\u003e\u003cspan address=\"10.1016/j.jacc.2013.11.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAssociation EMBoCS, Association SGoEMBoCM, Society EMBoCG, Education KLoEaTRoMo. Chinese Expert Consensus on the Diagnosis and Treatment of Stroke-Associated Pneumonia (2019 Update). Chinese Journal of Emergency Medicine. 2019;28(12):1476\u0026ndash;1484. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3969/j.issn.1002-1949.2019.12.002\u003c/span\u003e\u003cspan address=\"10.3969/j.issn.1002-1949.2019.12.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDiseases CSoR. Chinese Guidelines for the Diagnosis and Treatment of Community-Acquired Pneumonia in Adults (2016 Edition). Chinese Journal of Tuberculosis and Respiratory Diseases. 2016;39(04):253\u0026ndash;279. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.issn.1001-0939.2016.04.005\u003c/span\u003e\u003cspan address=\"10.3760/cma.j.issn.1001-0939.2016.04.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMagiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. Mar 2012;18(3):268\u0026ndash;81. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1469-0691.2011.03570.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1469-0691.2011.03570.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJin R, Zhu X, Liu L, Nanda A, Granger DN, Li G. Simvastatin attenuates stroke-induced splenic atrophy and lung susceptibility to spontaneous bacterial infection in mice. Stroke. Apr 2013;44(4):1135\u0026ndash;43. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/strokeaha.111.000633\u003c/span\u003e\u003cspan address=\"10.1161/strokeaha.111.000633\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang P, Zhang X, Huang Y, et al. Atorvastatin alleviates microglia-mediated neuroinflammation via modulating the microbial composition and the intestinal barrier function in ischemic stroke mice. Free Radic Biol Med. Jan 2021;162:104\u0026ndash;117. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.freeradbiomed.2020.11.032\u003c/span\u003e\u003cspan address=\"10.1016/j.freeradbiomed.2020.11.032\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGraziano TS, Cuzzullin MC, Franco GC, et al. Statins and Antimicrobial Effects: Simvastatin as a Potential Drug against Staphylococcus aureus Biofilm. PLoS One. 2015;10(5):e0128098. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0128098\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0128098\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHennessy E, Adams C, Reen FJ, O'Gara F. Is There Potential for Repurposing Statins as Novel Antimicrobials? Antimicrob Agents Chemother. Sep 2016;60(9):5111\u0026ndash;21. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1128/aac.00192-16\u003c/span\u003e\u003cspan address=\"10.1128/aac.00192-16\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThangamani S, Mohammad H, Abushahba MF, et al. Exploring simvastatin, an antihyperlipidemic drug, as a potential topical antibacterial agent. Sci Rep. Nov 10 2015;5:16407. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/srep16407\u003c/span\u003e\u003cspan address=\"10.1038/srep16407\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan der Meij E, Koning GG, Vriens PW, et al. A clinical evaluation of statin pleiotropy: statins selectively and dose-dependently reduce vascular inflammation. PLoS One. 2013;8(1):e53882. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0053882\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0053882\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOffner H, Subramanian S, Parker SM, Afentoulis ME, Vandenbark AA, Hurn PD. Experimental stroke induces massive, rapid activation of the peripheral immune system. J Cereb Blood Flow Metab. May 2006;26(5):654\u0026ndash;65. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/sj.jcbfm.9600217\u003c/span\u003e\u003cspan address=\"10.1038/sj.jcbfm.9600217\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOffner H, Subramanian S, Parker SM, et al. Splenic atrophy in experimental stroke is accompanied by increased regulatory T cells and circulating macrophages. J Immunol. Jun 1 2006;176(11):6523\u0026ndash;31. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4049/jimmunol.176.11.6523\u003c/span\u003e\u003cspan address=\"10.4049/jimmunol.176.11.6523\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu Q, Zhuang H, Xie Y. Study on the related risk factors and targeted nursing effects in multi-drug resistant bacteria infections in elderly patients with stroke-associated pneumonia. Am J Transl Res. 2021;13(8):9860\u0026ndash;9865.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu J, Yang Z. Risk factors and pathogenic microorganism characteristics for pneumonia in convalescent patients with stroke: A retrospective study of 380 patients from a rehabilitation hospital. J Stroke Cerebrovasc Dis. Aug 2020;29(8):104955. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jstrokecerebrovasdis.2020.104955\u003c/span\u003e\u003cspan address=\"10.1016/j.jstrokecerebrovasdis.2020.104955\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang CC, Yang PW, Yang SF, Hsieh KP, Tseng SP, Lin YC. Topical simvastatin promotes healing of Staphylococcus aureus-contaminated cutaneous wounds. Int Wound J. Dec 2016;13(6):1150\u0026ndash;1157. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/iwj.12431\u003c/span\u003e\u003cspan address=\"10.1111/iwj.12431\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoldstein JL, Brown MS. Regulation of the mevalonate pathway. Nature. Feb 1 1990;343(6257):425\u0026ndash;30. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/343425a0\u003c/span\u003e\u003cspan address=\"10.1038/343425a0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSkerry C, Pinn ML, Bruiners N, Pine R, Gennaro ML, Karakousis PC. Simvastatin increases the in vivo activity of the first-line tuberculosis regimen. J Antimicrob Chemother. Sep 2014;69(9):2453\u0026ndash;7. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/jac/dku166\u003c/span\u003e\u003cspan address=\"10.1093/jac/dku166\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. Jul 2021;52(7):e364-e467. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/str.0000000000000375\u003c/span\u003e\u003cspan address=\"10.1161/str.0000000000000375\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePowers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. Dec 2019;50(12):e344-e418. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/str.0000000000000211\u003c/span\u003e\u003cspan address=\"10.1161/str.0000000000000211\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Atorvastatin, Intensive treatment, Post-stroke pneumonia, Ischemic stroke","lastPublishedDoi":"10.21203/rs.3.rs-8842936/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8842936/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe use of intensive statin therapy in acute ischemic stroke (AIS) is common; however, its association with post-stroke pneumonia (PSP) remains uncertain. This study aimed to determine whether intensive-dose atorvastatin (\u0026ge;\u0026thinsp;40 mg/d) increases the risk, severity, or incidence of multidrug-resistant (MDR) bacterial infections in PSP compared to standard-dose therapy (20 mg/d).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe retrospectively analyzed 4,843 AIS patients admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2020 and January 2022. After applying inclusion and exclusion criteria, 3,199 patients were included. Propensity score matching (PSM) was used to balance baseline characteristics between the intensive and standard atorvastatin groups. The incidence of PSP, pneumonia severity (evaluated by CURB-65 scores), and MDR bacterial infection rates were compared. Multivariate logistic regression was applied to identify independent risk factors for PSP.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAfter PSM, no significant difference was observed in PSP incidence between the intensive and standard atorvastatin groups (8.8% vs. 8.3%, p\u0026thinsp;=\u0026thinsp;0.691). Multivariate regression confirmed that intensive treatment was not associated with increased PSP risk, either before (OR\u0026thinsp;=\u0026thinsp;1.074, 95% CI: 0.756\u0026ndash;1.525) or after matching (OR\u0026thinsp;=\u0026thinsp;1.002, 95% CI: 0.672\u0026ndash;1.492). Among the 173 PSP patients, there were no significant differences in the proportion of severe pneumonia (21.4% vs. 20.2%, p\u0026thinsp;=\u0026thinsp;0.863) or MDR bacterial infection incidence (9.5% vs. 10.1%, p\u0026thinsp;=\u0026thinsp;0.897) between the two groups.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIntensive atorvastatin treatment during the acute phase of ischemic stroke did not increase the risk or severity of pneumonia, nor did it elevate MDR bacterial infections. These findings support the safe use of statins in AIS patients and offer insights for optimizing clinical treatment strategies.\u003c/p\u003e\u003ch2\u003eClinical trial number:\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e","manuscriptTitle":"Intensive Versus Standard Statin Therapy in Acute Ischemic Stroke: A Comparative Study on the Risk of Pneumonia and Multidrug-Resistant Bacterial Infections","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-25 06:04:31","doi":"10.21203/rs.3.rs-8842936/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1dc66618-932b-42a2-b348-251e7a18923d","owner":[],"postedDate":"March 25th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-04-30T11:32:47+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-30T11:40:31+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-25 06:04:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8842936","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8842936","identity":"rs-8842936","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}