Nieves Sopena1, Eva Heras2, Irma Casas3, Jordi Bechini4, Ignasi Guasch4, Maria Luisa Pedro-Botet2, Silvia Roure2, Miquel Sabrià2. 1. Infectious Diseases Unit, Internal Medicine Department, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Badalona, Spain. Electronic address: nsopena.germanstrias@gencat.cat. 2. Infectious Diseases Unit, Internal Medicine Department, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Badalona, Spain. 3. Preventive Medicine Department, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Badalona, Spain. 4. Radiology Department, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Badalona, Spain.
Abstract
BACKGROUND: Hospital-acquired pneumonia (HAP) is one of the leading nosocomial infections and is associated with high morbidity and mortality. Numerous studies on HAP have been performed in intensive care units (ICUs), whereas very few have focused on patients in general wards. This study examined the incidence of, risk factors for, and outcomes of HAP outside the ICU. METHODS: An incident case-control study was conducted in a 600-bed hospital between January 2006 and April 2008. Each case of HAP was randomly matched with 2 paired controls. Data on risk factors, patient characteristics, and outcomes were collected. RESULTS: The study group comprised 119 patients with HAP and 238 controls. The incidence of HAP outside the ICU was 2.45 cases per 1,000 discharges. Multivariate analysis identified malnutrition, chronic renal failure, anemia, depression of consciousness, Charlson comorbidity index ≥3, previous hospitalization, and thoracic surgery as significant risk factors for HAP. Complications occurred in 57.1% patients. The mortality attributed to HAP was 27.7%. CONCLUSIONS: HAP outside the ICU prevailed in patients with malnutrition, chronic renal failure, anemia, depression of consciousness, comorbidity, recent hospitalization, and thoracic surgery. HAP in general wards carries an elevated morbidity and mortality and is associated with increased length of hospital stay and increased rate of discharge to a skilled nursing facility.
BACKGROUND: Hospital-acquired pneumonia (HAP) is one of the leading nosocomial infections and is associated with high morbidity and mortality. Numerous studies on HAP have been performed in intensive care units (ICUs), whereas very few have focused on patients in general wards. This study examined the incidence of, risk factors for, and outcomes of HAP outside the ICU. METHODS: An incident case-control study was conducted in a 600-bed hospital between January 2006 and April 2008. Each case of HAP was randomly matched with 2 paired controls. Data on risk factors, patient characteristics, and outcomes were collected. RESULTS: The study group comprised 119 patients with HAP and 238 controls. The incidence of HAP outside the ICU was 2.45 cases per 1,000 discharges. Multivariate analysis identified malnutrition, chronic renal failure, anemia, depression of consciousness, Charlson comorbidity index ≥3, previous hospitalization, and thoracic surgery as significant risk factors for HAP. Complications occurred in 57.1% patients. The mortality attributed to HAP was 27.7%. CONCLUSIONS: HAP outside the ICU prevailed in patients with malnutrition, chronic renal failure, anemia, depression of consciousness, comorbidity, recent hospitalization, and thoracic surgery. HAP in general wards carries an elevated morbidity and mortality and is associated with increased length of hospital stay and increased rate of discharge to a skilled nursing facility.
Authors: M Pozzi; P Pellegrino; S Galbiati; M Granziera; F Locatelli; C Carnovale; V Perrone; S Antoniazzi; C Perrotta; S Strazzer; E Clementi Journal: Eur J Clin Microbiol Infect Dis Date: 2014-08-09 Impact factor: 3.267
Authors: Ana Fernández-Cruz; Laura Ortega; Gonzalo García; Iria Gallego; Ana Álvarez-Uría; Esther Chamorro-de-Vega; José Javier García-López; Ricardo González-Del-Val; Pablo Martín-Rabadán; Carmen Rodríguez; María Luisa Pedro-Botet; Miguel Martín; Emilio Bouza Journal: Oncologist Date: 2020-02-11
Authors: Barbara Ebersole; Miriam Lango; John Ridge; Elizabeth Handorf; Jeffrey Farma; Sarah Clark; Nausheen Jamal Journal: Otolaryngol Head Neck Surg Date: 2019-12-03 Impact factor: 3.497
Authors: K Shirado; H Wakabayashi; K Maeda; A Nishiyama; M Asada; H Isse; S Saito; C Kakitani; R Momosaki Journal: J Nutr Health Aging Date: 2020 Impact factor: 4.075
Authors: Marta Di Pasquale; Stefano Aliberti; Marco Mantero; Sonia Bianchini; Francesco Blasi Journal: Int J Mol Sci Date: 2016-02-25 Impact factor: 5.923
Authors: Brendan J Kelly; Ize Imai; Kyle Bittinger; Alice Laughlin; Barry D Fuchs; Frederic D Bushman; Ronald G Collman Journal: Microbiome Date: 2016-02-11 Impact factor: 14.650