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Published on: February 23, 2014
[Risk factors of non-ICU nosocomial pneumonia]
F J Nicolás Sánchez1, M Vilá Justribó, M Rubio Caballero
1Servicio de Medicina Interna, Hospital Val d'Aran, Lleida.
Objective:
To know the incidence and risk's factors of nosocomial pneumonia (NN) in patient entered in hospital with age more of 14 years-old. The study was not performed in patients of Unit Care. Also, morbility and mortality are showed and the relation between bacterial agent and inmunologic answer of the patients. By other hand, we reported about specific clinical predictors for NN.
Materials And Methods:
During a period of twenty-two months, 103 cases of NN were diagnosed what supposed 0.34% of the patients entered in this period of time. The study has been carried out in the University Arnau of Vilanova Hospital in Lleida (HUAV), with a capacity of 435 beds. Factors of the patients' risk of NN were valued. Multivariate analysis has been carried out by means of the pattern Cox's regression for proportional risks.
Results:
About 66.99% of the patients had followed previous antibiotic treatment to the pneumonia episode, but only were significants those that had been treated with amoxicillin-clavulanic acid (28.15%, p = 0.0191). Blocking of the channels of the calcium were administered to 14.56% (p = 0.0030), and treatment with sedative drugs in 27.18% (p = 0.0397). Aerosol therapy was performed in 29 patients (28.15%, p = 0.0030). Nasogastric tube was performed in 19.41% of the patients (p = 0.0132). Creatinine was elevated in 31.42% (p < 0.05). The attributable mortality to the NN was of 33.9%, having a rate of higher mortality that the patients without NN. The agent etiologic was isolated in 23.3% of cases. The NN was polymicrobial in 8 cases with P. aeruginosa and S. aureus as the most frequents.
Conclusion:
In patients with several pathologies and treatments could be changed the immunologic answer and these patients are more predisposed to suffer NN. The mortality is associate to the age and others illness of the patient.
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