Abstract:ObjectiveTo explore the independent risk factors of nosocomial pulmonary infection (hospital-acquired pneumonia, HAP) subsequent to supratentorial spontaneous intracerebral hemorrhage (sICH) and identify high-risk individuals of complicating HAP. Methods 1 023 individuals diagnosed with supratentorial sICH between January 2014 and March 2020 were retrospectively reviewed and enrolled for “Risk Stratification and Minimally Invasive Surgery in Acute Intracerebral Hemorrhage Patients-a Prospective Multicenter Cohort Study (Risa-MIS-ICH study)”. HAP was considered as the primary outcome and basis of study grouping. Clinical indicators (HAP, demographic characteristics, imaging features, etc. ) were collected for univariable tests, and significant factors would be further enrolled for multivariable Logistic analysis. Results Univariable tests revealed 18 indicators (male gender, the shorter interval from onset to admission, higher temperature, rapid pulse, disturbance of consciousness, and massive intracerebral parenchymal hemorrhage, etc. ) contributing to HAP events with significance ( P <0.05). Further multivariable Logistic analysis indicated that only 5 risk factors remain independent significant ( P <0.05), including male gender (OR=1.607, 95%CI: 1.031-2.504, P =0.036), disturbance of consciousness (GCS=9-12 vs 13-15: OR=15.122, 95%CI: 4.400-51.973, P <0.001; GCS=3-8 vs 13-15: OR=18.504, 95%CI: 5.201-65.831, P <0.001), impaired living function (mRS: OR=1.618, 95%CI: 1.259-2.081, P <0.001), reducing intracranial pressure (ICP) medication (OR=2.216, 95%CI: 1.160-4.237, P =0.016), and therapeutic neurosurgical approach (OR=2.445, 95%CI: 1.351-4.427, P =0.003). Conclusions Male gender, disturbance of consciousness, impaired living function, reducing ICP medication, and therapeutic neurosurgical approach are reliable independent risk factors to predict HAP events, which may be applied to achieve early diagnosis, dosing, and further relevant prognosis improvement in high-risk individuals.