Estudio prospectivo caso control de los factores de riesgo y pronósticos de la neumonía nosocomial en los enfermos no ventilados.

Abstract

Background: _x000D_ Hospital-acquired pneumonia 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._x000D_ Methods:_x000D_ 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. A passive and active surveillance system based on daily review of chest radiology reports was applied. Data on risk factors, patient characteristics, and outcomes were collected._x000D_ Results:_x000D_ 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%. HAP in general wards is associated with increased length of hospital stay and increased rate of discharge to a skilled nursing facility._x000D_ Conclusions: _x000D_ The prevention of HAP in general wards should rely on interventions to modify the risk and the prognostic factors.

Date of Award	28 Apr 2014
Original language	Spanish
Supervisor	Nieves Sopena Galindo (Director) & Miquel Sabria Leal (Director)