Multivariate analysis of the factors associated with the risk of pneumonia in intensive care units
Braz. j. infect. dis
;
11(3): 339-344, June 2007. tab, graf
Article
in English
| LILACS
| ID: lil-457634
ABSTRACT
Pneumonia is the most frequent hospital infection in patients admitted to intensive care units (ICU) and is also responsible for the highest lethality rates, as well as an increase in both the duration and costs of hospitalization. The objective of this study was to identify predisposing factors for pneumonia. A prospective cohort study was carried out between June 1996 and June 1997, and included 540 patients admitted consecutively for periods greater than 24 hours to the adult ICU of the Londrina State University's Teaching Hospital. Of these, 83 (15.4 percent) developed pneumonia. All patients were analyzed with respect to various risk factors for hospital-acquired pneumonia. Univariate analysis identified the following factors: decreased level of consciousness, craniotomy, prior use of antibiotics, mechanical ventilation, nasogastric tube feeding, enteral feeding, aspiration of gastric contents, central venous catheter and the time spent in the ICU. Multivariate analysis identified four risk factors for pneumonia in the ICU: tracheotomy (RR = 1.09; 95 percentCI = 1.04-1.17), nasogastric tube feeding (RR = 1.11; 95 percentCI = 1.05-1.18), H2-blocker use (RR = 1.09; 95 percentCI = 1.05-1.14) and decreased level of consciousness (RR = 2.67; 95 percentCI = 1.43-5.04). In 56.6 percent of patients, pneumonia occurred within the first four days following ICU admission. The risk factors identified were all necessary for the treatment of the patient except for decreased level of consciousness, either present at admission or occurring during hospitalization due to deterioration in the clinical condition of the patient or to the use of sedatives.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Pneumonia
/
Cross Infection
/
Intensive Care Units
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2007
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Federal University of São Paulo/BR
/
State University of Londrina/BR
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