Stroke-Associated Pneumonia: Risk Factors and Discharge Status

Yurike Septianingrum; Ratna Yunita Sari; Erika Martining Wardani; Nur Ainiyah; Imamatul Faizah; Ah. Yusuf; Ika Yuni Widyawati

doi:10.14710/nmjn.v14i3.56841

DOI: https://doi.org/10.14710/nmjn.v14i3.56841

Stroke-Associated Pneumonia: Risk Factors and Discharge Status

*Yurike Septianingrum

- Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia

Ratna Yunita Sari - Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia

Erika Martining Wardani - Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia

Nur Ainiyah - Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia

Imamatul Faizah - Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia

Ah. Yusuf - Doctoral of Nursing Program, Faculty of Nursing, Universitas Airlangga, Indonesia

Ika Yuni Widyawati - Doctoral of Nursing Program, Faculty of Nursing, Universitas Airlangga, Indonesia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN56841,
    author = {Yurike Septianingrum and Ratna Sari and Erika Martining Wardani and Nur Ainiyah and Imamatul Faizah and Ah. Yusuf and Ika Yuni Widyawati},
    title = {Stroke-Associated Pneumonia: Risk Factors and Discharge Status},
    journal = {Nurse Media Journal of Nursing},
  volume = {14},
    number = {3},
    year = {2025},
    keywords = {Incidence; stroke; pneumonia; prognosis},
    abstract = {      Background:  Stroke-associated Pneumonia (SAP) is one of the complications that occur in stroke patients and is associated with worse clinical outcomes. Risk factors for SAP and its impact on discharge status remain unclear.   Purpose:  This study aims to determine the factors influencing the incidence of stroke-related pneumonia in the hospital and the patient's discharge status.   Methods:  A case-control study was conducted at a private hospital in Surabaya from January 2021 to 2022. Medical record data was reviewed to identify stroke patients with suspected or confirmed pneumonia, after which risk factors (age, gender, stroke type, length of stay, stroke frequency, dysphagia, diabetes mellitus, hypertension, COVID-19, and discharge status) associated with the occurrence of SAP were examined. We excluded diagnoses of diseases with clinical manifestations such as tuberculosis-like pneumonia, lung tumor, pulmonary edema, pulmonary embolism, pulmonary atelectasis, and incomplete or missing medical record data. Data analysis used the chi-square test to identify the risk factors for stroke-associated pneumonia.   Results:  One hundred sixty-three stroke patients treated in all inpatient rooms were diagnosed with pneumonia; 52.8% of them had confirmed pneumonia, while the rest were still suspected of pneumonia. Most pneumonia occurs in ischemic stroke patients (93,9%), first-time stroke patients (87,1%), experienced dysphagia (55,2%), length of stay less than 7 days (55,2%), hypertension (55,2%), diabetes mellitus (57,1%), and discharged home (84%). we also found as much as 12.9% inpatient mortality due to SAP. Dysphagia, DM, and COVID-19 were significantly correlated with the incidence of stroke-associated pneumonia (p=0.000).   Conclusion:  Stroke-associated pneumonia is a substantial medical complication among stroke patients affected by dysphagia, DM, and COVID-19. Screening for dysphagia is necessary for nurses to prevent SAP in stroke patients.        },
   issn = {2406-8799},  doi = {10.14710/nmjn.v14i3.56841},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/56841}
}

Citation Format:

Abstract

Background: Stroke-associated Pneumonia (SAP) is one of the complications that occur in stroke patients and is associated with worse clinical outcomes. Risk factors for SAP and its impact on discharge status remain unclear.

Purpose: This study aims to determine the factors influencing the incidence of stroke-related pneumonia in the hospital and the patient's discharge status.

Methods: A case-control study was conducted at a private hospital in Surabaya from January 2021 to 2022. Medical record data was reviewed to identify stroke patients with suspected or confirmed pneumonia, after which risk factors (age, gender, stroke type, length of stay, stroke frequency, dysphagia, diabetes mellitus, hypertension, COVID-19, and discharge status) associated with the occurrence of SAP were examined. We excluded diagnoses of diseases with clinical manifestations such as tuberculosis-like pneumonia, lung tumor, pulmonary edema, pulmonary embolism, pulmonary atelectasis, and incomplete or missing medical record data. Data analysis used the chi-square test to identify the risk factors for stroke-associated pneumonia.

Results: One hundred sixty-three stroke patients treated in all inpatient rooms were diagnosed with pneumonia; 52.8% of them had confirmed pneumonia, while the rest were still suspected of pneumonia. Most pneumonia occurs in ischemic stroke patients (93,9%), first-time stroke patients (87,1%), experienced dysphagia (55,2%), length of stay less than 7 days (55,2%), hypertension (55,2%), diabetes mellitus (57,1%), and discharged home (84%). we also found as much as 12.9% inpatient mortality due to SAP. Dysphagia, DM, and COVID-19 were significantly correlated with the incidence of stroke-associated pneumonia (p=0.000).

Conclusion: Stroke-associated pneumonia is a substantial medical complication among stroke patients affected by dysphagia, DM, and COVID-19. Screening for dysphagia is necessary for nurses to prevent SAP in stroke patients.

Fulltext

Keywords: Incidence; stroke; pneumonia; prognosis

Article Metrics:

Article Info

Section: Articles

Language : EN

In Vol 14, No 3 (2024): (December 2024) (in progress)

Recent articles

Walking Exercise and Its Effect on Functional Capacity and Productivity in Post-Coronary Artery Bypass Graft (CABG) Patients: A Randomized Controlled Trial Global Trends of Diabetic Erectile Dysfunction Research from 2012 to 2022: A Bibliometric and Visualized Study Interprofessional Education Perception among Faculty in Health Allied Professions in the Philippines: A Preliminary Study More recent articles

Most cited articles

Effect of Self-Efficacy Enhancing Education Program on Family Caregivers’ Competencies in Caring for Patients with mild Traumatic Brain Injury in Yogyakarta, Indonesia Correlation between Coping Strategies and Quality of Life among Myocardial Infarction Patients in Nepal Surgical Site Infection among Women Post Cesarean Section: An Integrative Review Perceived Ability to Practice in Disaster Management among Public Health Nurses in Aceh, Indonesia Emergency Training, Education And Perceived Clinical Skills For Tsunami Care Among Nurses In Banda Aceh, Indonesia More cited articles

Ali, A. N., Howe, J., Majid, A., Redgrave, J., Pownall, S., & Abdelhafiz, A. H. (2018). The economic cost of stroke-associated pneumonia in a UK setting. Topics in Stroke Rehabilitation, 25(3), 214–223. https://doi.org/10.1080/10749357.2017.1398482
Almeida, S. R. M., Bahia, M. M., Lima, F. O., Paschoal, I. A., Cardoso, T. A. M. O., & Li, L. M. (2015). Predictors of pneumonia in acute stroke in patients in an emergency unit. Arquivos de Neuro-Psiquiatria, 73(5), 415–419. https://doi.org/10.1590/0004-282X20150046
Alreshidi, M. S., AlRashidi, F. A., Tuppal, C. P., Prudencio, D. A. M., Alrashidi, N., Villagracia, R. W. A., & Villagracia, H. N. (2024). Nurses’ Knowledge on the Prevention of Ventilator-Associated Pneumonia (VAP) among Critically Ill Patients. Nurse Media Journal of Nursing, 14(1), 65–73. https://doi.org/10.14710/nmjn.v14i1.50955
Assefa, M., Tadesse, A., Adane, A., Yimer, M., & Tadesse, M. (2022). Factors associated with stroke associated pneumonia among adult stroke patients admitted to university of Gondar hospital, Northwest Ethiopia. Scientific Reports, 12(1), 1–8. https://doi.org/10.1038/s41598-022-14656-2
Azeem-ur-rehman, M., Saddique, M. A., Bilal, M., & Rauf, K. (2022). The frequency of stroke-acquired pneumonia in patients admitted to ICU with Cerebrovascular accident ( CVA ). Journal of Rawalpindi Medical College, 26(3), 491–496. https://doi.org/https://doi.org/10.37939/jrmc.v26i3.1947
Azzahra, A. D., Amalia, L., Calista, C., Dian, S., Aminah, S., & Ong, P. A. (2021). Comparison of Cognitive Function of Ischemic Stroke Patients with and without Pneumonia. Althea Medical Journal, 8(3), 164–169. https://doi.org/10.15850/amj.v8n3.2356
Barlas, R. S., Clark, A. B., Bettencourt-Silva, J. H., Sawanyawisuth, K., Kongbunkiat, K., Kasemsap, N., Tiamkao, S., & Myint, P. K. (2019). Pneumonia and Risk of Serious Adverse Outcomes in Hospitalized Strokes in Thailand. Journal of Stroke and Cerebrovascular Diseases, 28(6), 1448–1454. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.024
Chaves, M. L., Gittins, M., Bray, B., Vail, A., & Smith, C. J. (2022). Variation of stroke-associated pneumonia in stroke units across England and Wales: A registry-based cohort study. International Journal of Stroke, 17(2), 155–162. https://doi.org/10.1177/17474930211006297
Chen, J., Wu, Y., Chen, Z., Yi, B., Zhang, L., Yin, C., & Feng, H. (2020). High incidence of stroke in COVID-19 patients. Aging, 12(22), 22390–22398. https://doi.org/10.18632/aging.104092
Cugy, E., & Sibon, I. (2017). Stroke-Associated Pneumonia Risk Score: Validity in a French Stroke Unit. Journal of Stroke and Cerebrovascular Diseases, 26(1), 225–229. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.015
Ekayana, E., Fithrie, A., & Nasution, I. K. (2020). Bacterial Pattern and Antibiotics Sensitivity od Sepsis Stroke Patients in Neurology Inpatients Rooms of Haji Adam Malik General Hospital Medan. Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 36(2), 106–112. https://doi.org/10.52386/neurona.v36i2.62
Eltringham, S. A., Kilner, K., Gee, M., Sage, K., Bray, B. D., Pownall, S., & Smith, C. J. (2018). Impact of Dysphagia Assessment and Management on Risk of Stroke-Associated Pneumonia: A Systematic Review. Cerebrovascular Diseases, 46(3–4), 97–105. https://doi.org/10.1159/000492730
Feng, M. C., Lin, Y. C., Chang, Y. H., Chen, C. H., Chiang, H. C., Huang, L. C., Yang, Y. H., & Hung, C. H. (2019). The Mortality and the Risk of Aspiration Pneumonia Related with Dysphagia in Stroke Patients. Journal of Stroke and Cerebrovascular Diseases, 28(5), 1381–1387. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.02.011
Grossmann, I., Rodriguez, K., Soni, M., Joshi, P. K., Patel, S. C., Shreya, D., Zamora, D. I., Patel, G. S., & Sange, I. (2021). Stroke and Pneumonia: Mechanisms, Risk Factors, Management, and Prevention. Cureus, 13(11), 1–9. https://doi.org/10.7759/cureus.19912
Guo, F., Fan, Q., Liu, X., & Sun, D. (2022). Patient’s care bundle benefits to prevent stroke associated pneumonia: A meta-analysis with trial sequential analysis. Frontiers in Neurology, 13(4), 1–12. https://doi.org/10.3389/fneur.2022.950662
Haast, R. A. M., Gustafson, D. R., & Kiliaan, A. J. (2012). Sex differences in stroke. Journal of Cerebral Blood Flow and Metabolism, 32(12), 2100–2107. https://doi.org/10.1038/jcbfm.2012.141
Hannawi, Y., Hannawi, B., Rao, C. P. V., Suarez, J. I., & Bershad, E. M. (2013). Stroke-associated pneumonia: Major advances and obstacles. Cerebrovascular Diseases, 35(5), 430–443. https://doi.org/10.1159/000350199
Hess, D. C., Eldahshan, W., & Rutkowski, E. (2020). COVID-19-Related Stroke. Translational Stroke Research, 11(3), 322–325. https://doi.org/10.1007/s12975-020-00818-9
Hidayat, R., Widjaya, N., Djuliannisaa, Z., Mustika, A. P., Zairinal, R. A., Diafiri, D., Mesiano, T., Kurniawan, M., Rasyid, A., & Harris, S. (2022). Ischemic stroke in COVID-19 patients: a cross-sectional study from an Indonesian COVID-19 referral hospital. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 58(1), 93. https://doi.org/10.1186/s41983-022-00528-z
Ho, C. H., Lin, W. C., Hsu, Y. F., Lee, I. H., & Hung, Y. C. (2018). One-Year Risk of Pneumonia and Mortality in Patients with Poststroke Dysphagia: A Nationwide Population-Based Study. Journal of Stroke and Cerebrovascular Diseases, 27(5), 1311–1317. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.017
Hsieh, M.-T., Hsieh, C.-Y., Tsai, T.-T., Wang, Y.-C., & Sung, S.-F. (2020). Performance of ICD-10-CM Diagnosis Codes for Identifying Acute Ischemic Stroke in a National Health Insurance Claims Database. Clinical Epidemiology, 12(1), 1007–1013. https://doi.org/10.2147/CLEP.S273853
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5
Indonesia, K. K. R. I. (2019). Decree of the Minister of Health of the Republic of Indonesia Number HK.01.07 / MENKES / 394 / 2019 concerning National Guidelines for Medical Services for Stroke Management
Izza, A. Al, & Lailiyah, S. (2024). Kajian Literatur: Gambaran Implementasi Rekam Medis Elektronik di Rumah Sakit Indonesia berdasarkan Permenkes Nomor 24 Tahun 2022 tentang Rekam Medis. Media Gizi Kesmas, 13(1), 549–562. https://doi.org/10.20473/mgk.v13i1.2024.549-562
Kembuan, M. A. H. N., Mawuntu, A. H. P., Yohanna, Feliana, & Tumboimbela, M. J. (2021). Lower GCS is Related to Poor Outcome among Acute Stroke Patients with COVID-19 in A Tertiary Referral Hospital in Indonesia. Indonesian Biomedical Journal, 13(4), 409–417. https://doi.org/10.18585/INABJ.V13I4.1700
Li, Y. M., Zhao, L., Liu, Y. G., Lu, Y., Yao, J. Z., Li, C. J., Lu, W., & Xu, J. H. (2022). Novel Predictors of Stroke-Associated Pneumonia: A Single Center Analysis. Frontiers in Neurology, 13(March), 1–9. https://doi.org/10.3389/fneur.2022.857420
Li, Y., Zhang, Y., Ma, L., Niu, X., & Chang, J. (2019). Risk of stroke-associated pneumonia during hospitalization: Predictive ability of combined A2DS2 score and hyperglycemia. BMC Neurology, 19(1), 1–7. https://doi.org/10.1186/s12883-019-1497-x
Liao, C. C., Shih, C. C., Yeh, C. C., Chang, Y. C., Hu, C. J., Lin, J. G., & Chen, T. L. (2015). Impact of diabetes on stroke risk and outcomes: Two nationwide retrospective cohort studies. Medicine (United States), 94(52), 1–8. https://doi.org/10.1097/MD.0000000000002282
Lidetu, T., Muluneh, E. K., & Wassie, G. T. (2023). Incidence and Predictors of Aspiration Pneumonia Among Stroke Patients in Western Amhara Region, North-West Ethiopia: A Retrospective Follow Up Study. International Journal of General Medicine, 16(1), 1303–1315. https://doi.org/10.2147/IJGM.S400420
Liu, T., Zheng, J., Du, J., & He, G. (2024). Food Processing and Nutrition Strategies for Improving the Health of Elderly People with Dysphagia: A Review of Recent Developments. Foods, 13(2), 215. https://doi.org/10.3390/foods13020215
Liu, Z. Y., Wei, L., Ye, R. C., Chen, J., Nie, D., Zhang, G., & Zhang, X. P. (2022). Reducing the incidence of stroke-associated pneumonia: an evidence-based practice. BMC Neurology, 22(1), 1–9. https://doi.org/10.1186/s12883-022-02826-8
McCormick, N., Bhole, V., Lacaille, D., & Avina-Zubieta, J. A. (2015). Validity of Diagnostic Codes for Acute Stroke in Administrative Databases: A Systematic Review. PLOS ONE, 10(8), 1–26. https://doi.org/10.1371/journal.pone.0135834
Muhafidzah, N. F., Mansur, S., Hermiyanti Pranggono, E., Wibisono, Y., Juli, C., Gamayani, U., Gunadharma, S., & Cahyani, A. (2021). Faktor Faktor Risiko terjadinya Pneumonia pada Stroke Akut di RSUP Dr Hasan Sadikin Bandung. Jurnal Neuroanestesi Indonesia, 10(3), 151–161. https://doi.org/10.24244/jni.v10i3.269
Nannoni, S., de Groot, R., Bell, S., & Markus, H. S. (2021). Stroke in COVID-19: A systematic review and meta-analysis. International Journal of Stroke, 16(2), 137–149. https://doi.org/10.1177/1747493020972922
Nishiyama, Y., Miyamoto, S., Sakaguchi, M., Sakai, N., Yoshida, K., Tokuda, N., Ichi, S., Iguchi, Y., Koga, M., Yamaura, I., Hirano, T., Yamagami, H., & Kimura, K. (2024). Clinical characteristics of stroke in SARS-CoV-2 infected patients in Japan: A prospective nationwide study. Journal of the Neurological Sciences, 457(December 2023), 122865. https://doi.org/10.1016/j.jns.2023.122865
Nor Adina, A. T., Ahmad, M. A., Uduman, A., & Hamidon, B. B. (2012). Predictors of stroke-associated pneumonia after the first episode of acute ischaemic stroke. Malaysian Journal of Medicine and Health Sciences, 8(1), 37–43
Palli, C., Fandler, S., Doppelhofer, K., Niederkorn, K., Enzinger, C., Vetta, C., Trampusch, E., Schmidt, R., Fazekas, F., & Gattringer, T. (2017). Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients: A Clinical Intervention Study. Stroke, 48(9), 2583–2585. https://doi.org/10.1161/STROKEAHA.117.018157
Patmah, P., Mariana, E. R., & Purwati Ningsih, E. S. (2022). Literature Review Faktor yang Mempengaruhi Pneumonia Aspirasi pada Pasien Stroke dengan Disfagia. Jurnal Citra Keperawatan, 10(2), 73–80. https://doi.org/10.31964/jck.v10i2.260
Qureshi, A. I., Baskett, W. I., Huang, W., Shyu, D., Myers, D., Raju, M., Lobanova, I., Suri, M. F. K., Naqvi, S. H., French, B. R., Siddiq, F., Gomez, C. R., & Shyu, C.-R. (2021). Acute Ischemic Stroke and COVID-19. Stroke, 52(3), 905–912. https://doi.org/10.1161/STROKEAHA.120.031786
Ritonga, A. M., Syarif, S., & Soertidewi, L. (2019). Profil Mortalitas Stroke Associated Pneumonia Tahun 2016-2017. Jurnal Ilmu Dan Teknologi Kesehatan, 6(2), 104–112. https://doi.org/10.32668/jitek.v6i2.172
Sari, I. M., Soertidewi, L., Yokota, C., Kikuno, M., Koga, M., & Toyoda, K. (2017). Comparison of Characteristics of Stroke-Associated Pneumonia in Stroke Care Units in Indonesia and Japan. Journal of Stroke and Cerebrovascular Diseases, 26(2), 280–285. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.018
Sari, P. M., Agniana, A. M., & Ardhi, M. S. (2022). Trends of ischemic stroke admission during two years of COVID-19 pandemic: A retrospective cross-sectional study at a tertiary hospital in Indonesia. Bali Medical Journal, 11(2), 864–869. https://doi.org/10.15562/bmj.v11i2.3498
Smith, C. J., Kishore, A. K., Vail, A., Chamorro, A., Garau, J., Hopkins, S. J., Di Napoli, M., Kalra, L., Langhorne, P., Montaner, J., Roffe, C., Rudd, A. G., Tyrrell, P. J., van de Beek, D., Woodhead, M., & Meisel, A. (2015). Diagnosis of Stroke-Associated Pneumonia: Recommendations From the Pneumonia in Stroke Consensus Group. Stroke; a Journal of Cerebral Circulation, 46(8), 2335–2340. https://doi.org/10.1161/STROKEAHA.115.009617
Szylińska, A., Bott-Olejnik, M., Wańkowicz, P., Karoń, D., Rotter, I., & Kotfis, K. (2022). A Novel Index in the Prediction of Pneumonia Following Acute Ischemic Stroke. International Journal of Environmental Research and Public Health, 19(22), 15306. https://doi.org/10.3390/ijerph192215306
Tashima, H., Ito, M., Kawakami, M., Ishii, R., Miyazaki, Y., Akimoto, T., Tsujikawa, M., Kobayashi, K., Kondo, K., & Tsuji, T. (2023). Risk Factors for Post-Stroke Pneumonia in a Patient Population with Subacute Stroke: A Retrospective Cohort Study. Journal of Clinical Medicine, 12(18), 5835. https://doi.org/10.3390/jcm12185835
Teh, W. H., Smith, C. J., Barlas, R. S., Wood, A. D., Bettencourt-Silva, J. H., Clark, A. B., Metcalf, A. K., Bowles, K. M., Potter, J. F., & Myint, P. K. (2018). Impact of stroke-associated pneumonia on mortality, length of hospitalization, and functional outcome. Acta Neurologica Scandinavica, 138(4), 293–300. https://doi.org/10.1111/ane.12956
Theresia, S. I. M. (2016). Management for Preventing Ventilator-Associated Pneumonia at ICU Panti Rapih Hospital: A Clinical Case Study. Nurse Media Journal of Nursing, 6(1), 30–36. https://doi.org/10.14710/nmjn.v6i1.11818
Tinker, R. J., Smith, C. J., Heal, C., Bettencourt-Silva, J. H., Metcalf, A. K., Potter, J. F., & Myint, P. K. (2021). Predictors of mortality and disability in stroke-associated pneumonia. Acta Neurologica Belgica, 121(2), 379–385. https://doi.org/10.1007/s13760-019-01148-w
Wandira, R. D., Amalia, L., & Fuadi, I. (2018). HAssociation Between Stroke Severity and Stroke-Associated Pneumonia. Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 35(2), 3–7. https://doi.org/10.52386/neurona.v35i2.20
Wang, Y., Dai, Y., Zheng, J., Xie, Y., Guo, R., Guo, X., Sun, G., Sun, Z., Sun, Y., & Zheng, L. (2019). Sex difference in the incidence of stroke and its corresponding influence factors: Results from a follow-up 8.4 years of rural China hypertensive prospective cohort study. Lipids in Health and Disease, 18(1), 1–10. https://doi.org/10.1186/s12944-019-1010-y
Wei, M., Huang, Q., Yu, F., Feng, X., Luo, Y., Zhao, T., Tu, R., Liao, D., Du, Y., Huang, Q., Gu, W., Liu, Y., Jiang, Y., Gu, H., Li, Z., & Xia, J. (2022). Stroke-associated infection in patients with co-morbid diabetes mellitus is associated with in-hospital mortality. Frontiers in Aging Neuroscience, 14(December), 1–11. https://doi.org/10.3389/fnagi.2022.1024496
Widyantara, I. W., Purwata, T. E., Putra, I. K., Ariswanda, I. G., Widyadharma, I. E., Candrawati, N. W., & Andrika, P. (2020). Factors That Affecting the Event of Pneumonia in Stroke Patients Treated in the Intensive Space of Sanglah Denpasar Hospital. International Journal of Medical Reviews and Case Reports, 4(0), 1. https://doi.org/10.5455/ijmrcr.pneumonia-stroke
Yuan, M., Li, Q., Zhang, R., Zhang, W., Zou, N., Qin, X., & Cai, Z. (2021). Risk factors for and impact of poststroke pneumonia in patients with acute ischemic stroke. Medicine, 100(12), e25213. https://doi.org/10.1097/MD.0000000000025213
Zhai, P., Ding, Y., & Li, Y. (2020). The impact of COVID-19 on ischemic stroke. Diagnostic Pathology, 15(1), 78. https://doi.org/10.1186/s13000-020-00994-0

Last update:

No citation recorded.

Last update: 2025-05-08 03:48:56

No citation recorded.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Journal Author(s) Rights

In order for the Department of Nursing, Faculty of Medicine, Universitas Diponegoro to publish and disseminate research articles, we need non-exclusive publishing rights (transferred from the author(s) to the publisher). This is determined by a publishing agreement between the author(s) and the Department of Nursing, Faculty of Medicine, Universitas Diponegoro. This agreement involves the transfer or licensing of the copyright for publishing to the publisher, while authors still retain significant rights to use and share their own published articles. The Department of Nursing, Faculty of Medicine, Universitas Diponegoro supports the need for authors to share, disseminate, and maximize the impact of their research through these rights in any databases.

As the author(s), you have rights to a wide range of uses of your article, including use by your employing institution or company. These author rights can be exercised without the need to obtain specific permission. Authors publishing in the Nurse Media Journal of Nursing have extensive rights to use their works for teaching and scholarly purposes without needing to seek permission, including:

use for classroom teaching by the author or the author’s institution and presentation at a meeting or conference, including distributing copies to attendees;
use for internal training by the author’s company;
distribution to colleagues for their research use;
use in a subsequent compilation of the author’s works;
inclusion in a thesis or dissertation;
reuse of portions or extracts from the article in other works (with full acknowledgment of the final article);
preparation of derivative works (other than for commercial purposes) (with full acknowledgment of the final article);
voluntary posting on open websites operated by the author or the author’s institution for scholarly purposes;

following the open access license of the Creative Commons CC BY-SA License.

Authors, readers, and third parties can copy and redistribute the material in any medium or format, as well as remix, transform, and build upon the material for any purpose, even commercially, but they must give appropriate credit (including the name of the creator and attribution parties, detailed information about the authors, a copyright notice, an open access license notice, a disclaimer notice, and a link to the material), provide a link to the license, and indicate if changes were made. The publisher will indicate any modification of the material (if any) and retain an indication of previous modifications using a CrossMark Policy and information about Erratum-Corrigendum notifications.

Authors, readers, and third parties can read, print, and download, redistribute or republish the article (e.g., display it in a repository), translate the article, download it for text and data mining purposes, reuse portions or extracts from the article in other works, sell or reuse it for commercial purposes, remix, transform, or build upon the material. They must distribute their contributions under the same license as the original Creative Commons Attribution-ShareAlike (CC BY-SA).

Copyright Transfer Agreement for Publishing (Publishing Right)

The Authors submitting a manuscript do so on the understanding that if accepted for publication, non-exclusive right for publishing (publishing right) of the article shall be assigned/transferred to Publisher of the Nurse Media Journal of Nursing (Department of Nursing, Faculty of Medicine, Universitas Diponegoro).

Upon acceptance of an article, authors will be asked to complete a 'Copyright Transfer Agreement for Publishing (CTAP)'. An e-mail will be sent to the Corresponding Author confirming receipt of the manuscript together with a 'Copyright Transfer Agreement for Publishing' form by online version of this agreement.

Nurse Media Journal of Nursing and Department of Nursing, Faculty of Medicine, Universitas Diponegoro, the Editors and the Editorial Board make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in the Nurse Media Journal of Nursing are sole and exclusive responsibility of their respective authors and advertisers.

Please note that even though we ask for a transfer of copyright for publishing (CTAP), our journal Author(s) retain (or are granted back) significant scholarly rights as mentioned before.

The Copyright Transfer Agreement for Publishing (CTAP) Form can be downloaded here: [Copyright Transfer Agreement for Publishing (CTAP) Form NMJN 2024]

The copyright form should be signed electronically and send to the Editorial Office in the form of original e-mail below:

Dr. Meira Erawati (Editor-in-Chief)
Editorial Office of Nurse Media Journal of Nursing
Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Jl. Prof. Soedarto, Tembalang, Semarang, Central Java, Indonesia 50275
Telp.: +62-24-76480919; Fax.: +62-24-76486849
E-mail: media_ners@live.undip.ac.id

(This policy statements has been updated at 24th January 2024)

Stroke-Associated Pneumonia: Risk Factors and Discharge Status

Journal Author(s) Rights

Copyright Transfer Agreement for Publishing (Publishing Right)

OFFICE INFORMATION