Nosocomial pneumonia and mortality among patients in intensive care units
Nosocomial pneumonia and mortality among patients in intensive care units
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DOI：
10.1001/jama.275.11.866
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发表时间：
1996-03-20
影响因子：
120.7
通讯作者：
Gibert, C
中科院分区：
文献类型：
--
作者：
Fagon, JY;Chastre, J;Gibert, C
客观。-评估医院获得性肺炎在重症监护病房（ICU）患者预后中的作用。队列研究。设置。-医学ICU，医院Bichat，巴黎，法国，一个学术三级护理中心。共有1978名连续患者入住ICU至少48小时。主要结果测量。记录了已知与ICU患者死亡密切相关的各种参数：年龄、入住ICU前的位置、诊断类别、急性生理学和慢性健康评估（APACHE）II评分、简化急性生理学评分、McCabe评分、功能障碍器官的数量和类型、医院内菌血症和医院内尿路感染的发生。这些变量和医院获得性肺炎的存在或不存在进行了比较幸存者和非幸存者，并进入逐步逻辑回归模型，以评估其独立的预后作用。ICU获得性肺炎328例（16.6%），病死率52.4%，而非ICU获得性肺炎的病死率为22.4%（P
Objective.-To evaluate the role that nosocomial pneumonia plays in the outcome of intensive care unit (ICU) patients.Design.-Cohort study.Setting.-Medical ICU, Hospital Bichat, Paris, France, an academic tertiary care center.Patients.-A total of 1978 consecutive patients admitted to the ICU for at least 48 hours.Main Outcome Measures.-Various parameters known to be strongly associated with death of ICU patients were recorded: age, location before admission to the ICU, diagnostic categories, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiologic Score, McCabe score, number and type of dysfunctional organs, and the development of nosocomial bacteremia and nosocomial urinary tract infection. These variables and the presence or absence of nosocomial pneumonia were compared between survivors and nonsurvivors and entered into a stepwise logistic regression model to evaluate their independent prognostic roles.Results.-Nosocomial pneumonia developed in 328 patients (16.6%) whose mortality rate was 52.4% compared with 22.4% for patients without ICU-acquired pneumonia (P