To investigate the risk factors and clinical analysis of lower respiratory tract infection after craniotomy in patients with acute hemorrhagic stroke.

The clinical data of 674 patients with hemorrhagic stroke who underwent craniotomy in Neurosurgery Department of Tianjin TEDA Hospital from January 2012 to December 2020 were selected, including gender, age, bleeding site, disturbance of consciousness, pupil changes, history of diabetes, history of chronic obstructive pulmonary disease (COPD). According to whether the patients were complicated with lower respiratory tract infection or not, the patients were divided into lower respiratory tract infection group and no lower respiratory tract infection group. Univariate analysis was used to analyze the differences of clinical data between the two groups, and the pathogenic bacteria and medication methods of lower respiratory tract infection were summarized.

There were 239 cases of lower respiratory tract infection and 435 cases of no respiratory tract infection in 674 patients. There were significant differences in age, state of consciousness, preoperative mydriasis, history of diabetes and COPD between the two groups (P<0.05). The pathogenic bacteria of lower respiratory tract infection were G^- bacteria accounted for 68.4%, G⁺ bacteria 29.8%, fungi 1.8%. The average hospitalization time of lower respiratory tract infection group was 18.23 d. The average length of stay in the group without lower respiratory tract infection was 14.47 d.

The incidence rate of lower respiratory tract infection after hemorrhagic stroke is related to the age, state of consciousness, pupil changes, diabetes history, COPD history and other clinical characteristics. Early targeted anti-inflammatory treatment can reduce the incidence rate of lower respiratory tract infection and improve the prognosis of patients after operation.