Analysis of risk factors of hospital-acquired pneumonia after craniocerebral trauma / 中国医师进修杂志

ABSTRACT

Objective:To analyze the risk factors of hospital-acquired pneumonia (HAP) after craniocerebral trauma.Methods:A total of 329 patients undergoing craniocerebral trauma surgery from December 2014 to December 2019 in Yicheng People′s Hospital of Zaozhuang City were enrolled. The data were reviewed and divided into HAP group (42 patients) and non-HAP group (287 patients) according to whether HAP occurred after surgery. The age, onset to operation time, surgery duration, and hospital stay between the two groups were compared. The differences of preoperative factors, intraoperative factors and postoperative factors between the two groups were compared. The risk factors of HAP after craniocerebral trauma were analyzed by Logistic multi-factor regression analysis.Results:The age, onset to operation time, surgery duration, hospital stay in HAP group were longer than those in the non-HAP group (55.09 ± 8.14) years vs. (45.98 ± 8.06) years, (9.65 ± 0.54) h vs. (7.43 ± 0.72) h, (332.54 ± 72.65 )min vs. (281.09 ± 78.54) min, (17.13 ± 2.56) d vs. (5.02 ± 3.09), the differences were statistically significant ( P<0.05). The differences in the types of brain diseases between the two groups were statistically significant ( P<0.05). The results of single factor analysis showed that the history of pulmonary disease, scores of Glasgow Coma Scale (GCS) < 8 points and ≥8 points, whether or not emergency operation, preoperatie antibiotics, reintubated, endotracheal intubation, indwelling gastric tube, and raise the head of a bed 30° to 45°, proton pump inhibitors, craniocerebral trauma and non traumatic diseases, mechanical ventilation, floor nutrition start time, giving glucocorticoid between the HAP group and non-HAP group had significant difference ( P<0.05). The Logistic multi-factor regression analysis showed that the age >50 years old, surgery duration >4 h, preoperative GCS<8 points, emergency surgery, tracheotomy and indwelling gastric tube were independent risk factors of HAP after surgery ( P<0.05). Conclusions:For patients undergoing surgical treatment of craniocerebral trauma, it is necessary to estimate the risk of postoperative HAP based on age, preoperative GCS score, elective surgery after emergency, operation time, and control risk factors.