{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:05:21Z","timestamp":1791475521737,"version":"4.3.4"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071148"],"award-info":[{"award-number":["82071148"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Stroke-associated pneumonia (SAP) is a common complication of stroke that can increase the mortality rate of patients and the burden on their families. In contrast to prior clinical scoring models that rely on baseline data, we propose constructing models based on brain CT scans due to their accessibility and clinical universality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our study aims to explore the mechanism behind the distribution and lesion areas of intracerebral hemorrhage (ICH) in relation to pneumonia, we utilized an MRI atlas that could present brain structures and a registration method in our program to extract features that may represent this relationship. We developed three machine learning models to predict the occurrence of SAP using these features. Ten-fold cross-validation was applied to evaluate the performance of models. Additionally, we constructed a probability map through statistical analysis that could display which brain regions are more frequently impacted by hematoma in patients with SAP based on four types of pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our study included a cohort of 244 patients, and we extracted 35 features that captured the invasion of ICH to different brain regions for model development. We evaluated the performance of three machine learning models, namely, logistic regression, support vector machine, and random forest, in predicting SAP, and the AUCs for these models ranged from 0.77 to 0.82. The probability map revealed that the distribution of ICH varied between the left and right brain hemispheres in patients with moderate and severe SAP, and we identified several brain structures, including the left-choroid-plexus, right-choroid-plexus, right-hippocampus, and left-hippocampus, that were more closely related to SAP based on feature selection. Additionally, we observed that some statistical indicators of ICH volume, such as mean and maximum values, were proportional to the severity of SAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our findings suggest that our method is effective in classifying the development of pneumonia based on brain CT scans. Furthermore, we identified distinct characteristics, such as volume and distribution, of ICH in four different types of SAP.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1139048","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T12:36:19Z","timestamp":1685709379000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["A brain CT-based approach for predicting and analyzing stroke-associated pneumonia from intracerebral hemorrhage"],"prefix":"10.3389","volume":"14","author":[{"given":"Guangtong","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfeng","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongmei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"175628641987326","DOI":"10.1177\/1756286419873264","article-title":"Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome","volume":"12","author":"Li","year":"2019","journal-title":"Therapeut Adv Neurol Disord."},{"key":"B2","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.jinf.2019.06.012","article-title":"Pneumonia in acute ischemic stroke patients requiring invasive ventilation: impact on short and long-term outcomes","volume":"79","author":"Montmollin","year":"2019","journal-title":"J Infect."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e006710","DOI":"10.1136\/bmjopen-2014-006710","article-title":"Population-based cohort study on the risk of pneumonia in patients with non-traumatic intracranial haemorrhage who use proton pump inhibitors","volume":"4","author":"Ho","year":"2014","journal-title":"BMJ Open"},{"key":"B4","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1159\/000350199","article-title":"Stroke-associated pneumonia: major advances and obstacles","volume":"35","author":"Hannawi","year":"2013","journal-title":"Cerebrovasc Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1161\/STROKEAHA.114.007843","article-title":"How is pneumonia diagnosed in clinical stroke research? 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