Risk factors for nosocomial pneumonia : comparing adult critical-care populations
The purpose of the study was to examine risk factors for nosocomial pneumonia in the surgical and medical/respiratory intensive care unit (ICU) populations. In a public teaching hospital, all cases of nosocomial pneumonia in the surgical and medical/respiratory ICUs (n = 20, respectively) were ident...
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| Veröffentlicht in: | American journal of respiratory and critical care medicine 1996, Vol.153 (1), p.158-162 |
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| container_title | American journal of respiratory and critical care medicine |
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| creator | CUNNION, K. M WEBER, D. J BROADHEAD, W. E HANSON, L. C PIEPER, C. F RUTALA, W. A |
| description | The purpose of the study was to examine risk factors for nosocomial pneumonia in the surgical and medical/respiratory intensive care unit (ICU) populations. In a public teaching hospital, all cases of nosocomial pneumonia in the surgical and medical/respiratory ICUs (n = 20, respectively) were identified by prospective surveillance during a 5-yr period from 1987-1991. Each group of ICU cases was compared with 40 ICU control patients who did not acquire pneumonia, and analyzed for 25 potential risk factors. Surgical ICU patients were found to have consistently higher rates of nosocomial pneumonia than medical ICU patients (RR = 2.2). The strongest predictor for nosocomial pneumonia in both the surgical and medical/respiratory ICU groups was found to be prolonged mechanical ventilation (> 1 d) resulting in a 12-fold increase in risk over nonventilated patients. APACHE III score was found to be predictive of nosocomial pneumonia in the surgical ICU population, but not in the medical/respiratory ICU population. We conclude that certain groups deserve special attention for infection control intervention. Surgical ICU patients with high APACHE scores and receiving prolonged mechanical ventilation may be at the greatest risk of acquiring nosocomial pneumonia of all hospitalized patients. |
| doi_str_mv | 10.1164/ajrccm.153.1.8542110 |
| format | Article |
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M ; WEBER, D. J ; BROADHEAD, W. E ; HANSON, L. C ; PIEPER, C. F ; RUTALA, W. A</creator><creatorcontrib>CUNNION, K. M ; WEBER, D. J ; BROADHEAD, W. E ; HANSON, L. C ; PIEPER, C. F ; RUTALA, W. A</creatorcontrib><description>The purpose of the study was to examine risk factors for nosocomial pneumonia in the surgical and medical/respiratory intensive care unit (ICU) populations. In a public teaching hospital, all cases of nosocomial pneumonia in the surgical and medical/respiratory ICUs (n = 20, respectively) were identified by prospective surveillance during a 5-yr period from 1987-1991. Each group of ICU cases was compared with 40 ICU control patients who did not acquire pneumonia, and analyzed for 25 potential risk factors. Surgical ICU patients were found to have consistently higher rates of nosocomial pneumonia than medical ICU patients (RR = 2.2). The strongest predictor for nosocomial pneumonia in both the surgical and medical/respiratory ICU groups was found to be prolonged mechanical ventilation (> 1 d) resulting in a 12-fold increase in risk over nonventilated patients. APACHE III score was found to be predictive of nosocomial pneumonia in the surgical ICU population, but not in the medical/respiratory ICU population. We conclude that certain groups deserve special attention for infection control intervention. Surgical ICU patients with high APACHE scores and receiving prolonged mechanical ventilation may be at the greatest risk of acquiring nosocomial pneumonia of all hospitalized patients.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/ajrccm.153.1.8542110</identifier><identifier>PMID: 8542110</identifier><language>eng</language><publisher>New York, NY: American Lung Association</publisher><subject>Adult ; Analysis of Variance ; APACHE ; Bacterial diseases ; Bacterial diseases of the respiratory system ; Biological and medical sciences ; Critical Care ; Cross Infection - etiology ; Cross Infection - mortality ; Female ; Hospitals, Teaching ; Human bacterial diseases ; Humans ; Infectious diseases ; Intensive Care Units ; Length of Stay ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Pneumonia - etiology ; Pneumonia - mortality ; Postoperative Complications ; Prospective Studies ; Respiration, Artificial - adverse effects ; Respiratory Care Units ; Risk Factors ; Treatment Outcome</subject><ispartof>American journal of respiratory and critical care medicine, 1996, Vol.153 (1), p.158-162</ispartof><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-aaca5d5ef92e51d7d666809e9d251ea0b07906be6cc5ce5a5d0f3f2a07882a833</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2962130$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8542110$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CUNNION, K. 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Surgical ICU patients were found to have consistently higher rates of nosocomial pneumonia than medical ICU patients (RR = 2.2). The strongest predictor for nosocomial pneumonia in both the surgical and medical/respiratory ICU groups was found to be prolonged mechanical ventilation (> 1 d) resulting in a 12-fold increase in risk over nonventilated patients. APACHE III score was found to be predictive of nosocomial pneumonia in the surgical ICU population, but not in the medical/respiratory ICU population. We conclude that certain groups deserve special attention for infection control intervention. Surgical ICU patients with high APACHE scores and receiving prolonged mechanical ventilation may be at the greatest risk of acquiring nosocomial pneumonia of all hospitalized patients.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>APACHE</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the respiratory system</subject><subject>Biological and medical sciences</subject><subject>Critical Care</subject><subject>Cross Infection - etiology</subject><subject>Cross Infection - mortality</subject><subject>Female</subject><subject>Hospitals, Teaching</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumonia - etiology</subject><subject>Pneumonia - mortality</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Respiratory Care Units</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtKxDAUhoMo4zj6BgpZiLuOSZqkrTsZvMGAKAruwpk0kYxtU5N24dsbmTKuzu07_-JD6JySJaWSX8M2aN0uqciXdFkKziglB2ieZpHxqiCHqSdFnnFefRyjkxi3hFBWUjJDswmfo5dXF7-wBT34ELH1AXc-eu1bBw3uOzO2vnOAb3Ba9RBc94mhHpsB6-AGp6HJNASDe9-PDQzOd_EUHVloojmb6gK939-9rR6z9fPD0-p2nWnO8yED0CBqYWzFjKB1UUspS1KZqmaCGiAbUlREbozUWmgjEktsbhmQoiwZlHm-QFe73D7479HEQbUuatM00Bk_RlUUlRCS8gTyHaiDjzEYq_rgWgg_ihL1Z1LtTKpkTlE1qUlvF1P-uGlNvX_6v19Od4jJgw3QaRf3GKskoznJfwFksH6Q</recordid><startdate>1996</startdate><enddate>1996</enddate><creator>CUNNION, K. M</creator><creator>WEBER, D. J</creator><creator>BROADHEAD, W. E</creator><creator>HANSON, L. C</creator><creator>PIEPER, C. F</creator><creator>RUTALA, W. A</creator><general>American Lung Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1996</creationdate><title>Risk factors for nosocomial pneumonia : comparing adult critical-care populations</title><author>CUNNION, K. M ; WEBER, D. J ; BROADHEAD, W. E ; HANSON, L. C ; PIEPER, C. F ; RUTALA, W. A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-aaca5d5ef92e51d7d666809e9d251ea0b07906be6cc5ce5a5d0f3f2a07882a833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Analysis of Variance</topic><topic>APACHE</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the respiratory system</topic><topic>Biological and medical sciences</topic><topic>Critical Care</topic><topic>Cross Infection - etiology</topic><topic>Cross Infection - mortality</topic><topic>Female</topic><topic>Hospitals, Teaching</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumonia - etiology</topic><topic>Pneumonia - mortality</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Respiratory Care Units</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CUNNION, K. M</creatorcontrib><creatorcontrib>WEBER, D. J</creatorcontrib><creatorcontrib>BROADHEAD, W. E</creatorcontrib><creatorcontrib>HANSON, L. C</creatorcontrib><creatorcontrib>PIEPER, C. F</creatorcontrib><creatorcontrib>RUTALA, W. A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CUNNION, K. M</au><au>WEBER, D. J</au><au>BROADHEAD, W. E</au><au>HANSON, L. C</au><au>PIEPER, C. F</au><au>RUTALA, W. 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Surgical ICU patients were found to have consistently higher rates of nosocomial pneumonia than medical ICU patients (RR = 2.2). The strongest predictor for nosocomial pneumonia in both the surgical and medical/respiratory ICU groups was found to be prolonged mechanical ventilation (> 1 d) resulting in a 12-fold increase in risk over nonventilated patients. APACHE III score was found to be predictive of nosocomial pneumonia in the surgical ICU population, but not in the medical/respiratory ICU population. We conclude that certain groups deserve special attention for infection control intervention. Surgical ICU patients with high APACHE scores and receiving prolonged mechanical ventilation may be at the greatest risk of acquiring nosocomial pneumonia of all hospitalized patients.</abstract><cop>New York, NY</cop><pub>American Lung Association</pub><pmid>8542110</pmid><doi>10.1164/ajrccm.153.1.8542110</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Analysis of Variance APACHE Bacterial diseases Bacterial diseases of the respiratory system Biological and medical sciences Critical Care Cross Infection - etiology Cross Infection - mortality Female Hospitals, Teaching Human bacterial diseases Humans Infectious diseases Intensive Care Units Length of Stay Logistic Models Male Medical sciences Middle Aged Pneumonia - etiology Pneumonia - mortality Postoperative Complications Prospective Studies Respiration, Artificial - adverse effects Respiratory Care Units Risk Factors Treatment Outcome |
| title | Risk factors for nosocomial pneumonia : comparing adult critical-care populations |
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