Risk factors for nosocomial pneumonia: Comparing adult critical-care populations
Risk factors for nosocomial pneumonia: Comparing adult critical-care populations
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DOI：
10.1164/ajrccm.153.1.8542110
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发表时间：
1996-01-01
影响因子：
24.7
通讯作者：
Rutala, WA
中科院分区：
文献类型：
--
作者：
Cunnion, KM;Weber, DJ;Rutala, WA
这项研究的目的是调查外科和内科/呼吸重症监护病房(ICU)人群中医院内肺炎的危险因素。在一家公立教学医院，所有外科和内科/呼吸科ICU(n=20)的医院获得性肺炎病例都是在1987-1991年的5年间通过前瞻性监测确定的。将每组ICU病例与40名未患肺炎的ICU对照组患者进行比较，并分析25个潜在危险因素。外科ICU患者的医院获得性肺炎发生率始终高于内科ICU患者(RR=2.2)。在外科和内科/呼吸科ICU组中，院内肺炎的最强预测因子被发现是长时间的机械通气(>；1d)，导致风险是未进行机械通气患者的12倍。在外科ICU人群中，APACHE III评分被发现可以预测医院内肺炎，但在内科/呼吸科ICU人群中则不能。我们的结论是，某些群体值得特别关注感染控制干预。在所有住院患者中，APACHE评分高、机械通气时间长的外科ICU患者感染医院内肺炎的风险最大。
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.