PDF(Pubmed)
Abstract：
Non-ventilator associated hospital-acquired pneumonia (nvHAP) is a common nosocomial infection, but little is known about the outcomes of patients with nvHAP and the risk factors for adverse outcomes. In this retrospective study conducted in a Swiss tertiary care centre, adverse outcomes like in-hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation, both all-cause and nvHAP-associated, were investigated. Of 244 patients with nvHAP, 72 (30%) died, 35 (14%) deaths were attributed to nvHAP. While 36 (15%) patients acquired nvHAP on the ICU, another 173 patients were eligible for ICU-transferral, and 76 (43.9%) needed ICU-admission. Of all patients hospitalized on the ICU 58 (51.8%) needed intubation due to nvHAP. Multivariable logistic regression analysis identified lower body mass index (OR per unit increase: 0.90, 95%CI: 0.82-0.98) and lower haemoglobin on admission (OR per unit in g/l increase: 0.98, 95%CI: 0.97-1.00) as patient specific factors independently associated with nvHAP-associated mortality. Given the frequency of nvHAP adverse outcomes, hospitals should evaluate increasing nvHAP prevention efforts, especially for patients at high risk for nvHAP mortality. To what extent pneumonia prevention interventions do lower nvHAP mortality in these patients is still to be evaluated.
摘要：
非呼吸机相关医院获得性肺炎(nvHAP)是一种常见的医院感染,但对nvHAP患者的结局和不良结局的危险因素知之甚少.在这项在瑞士三级护理中心进行的回顾性研究中，不良结果，如住院死亡率，重症监护病房(ICU)入院,机械通气,所有原因和nvHAP相关，被调查了。在244例nvHAP患者中，72人（30%）死亡，35例（14％）死亡归因于nvHAP。虽然36例(15%)患者在ICU获得nvHAP，另有173例患者符合ICU转诊条件，76人(43.9%)需要入住ICU.在ICU住院的所有患者中，有58例（51.8％）由于nvHAP而需要插管。多变量逻辑回归分析确定了入院时体重指数较低（OR每单位增加：0.90，95CI：0.82-0.98）和血红蛋白较低（OR每单位以g/l增加：0.98，95CI：0.97-1.00）作为患者特定因素与nvHAP相关死亡率独立相关。鉴于nvHAP不良后果的频率，医院应该评估越来越多的nvHAP预防工作，特别是对于nvHAP死亡率高的患者。肺炎预防干预措施在这些患者中降低nvHAP死亡率的程度仍有待评估。
