title: A retrospective study of nosocomial pneumonia at a long-term care facility.
abstract: BACKGROUND
  Results of a passive surveillance system (pneumonia confirmed by x-ray examination) suggested that in 1989 a total of 187 cases of nosocomial pneumonia had occurred at the Canandaigua Veterans Administration Medical Center among 250 long-term care patients.
  
  
  METHODS
  A retrospective study was undertaken to validate cases and to enumerate risk factors. A chart review showed that 136 of 187 cases (72%) met predetermined criteria for nosocomial pneumonia.
  
  
  RESULTS
  Three nursing units characterized as at high risk had a pneumonia rate of 1.90 per 1000 patient days, as compared with a rate of 0.70 cases per 1000 patient days on the two other units. There were no differences in age, mean white blood cell count, or clinical symptoms between high- and average-risk patients. Two thirds of all patients had a history of chronic aspiration. High-risk patients were more likely to be confined to bed, to have a debilitating neurologic disease, and to require tube feedings. Twenty percent of patients on high-risk units died of nosocomial pneumonia or with nosocomial pneumonia as a contributory factor.
  
  
  CONCLUSIONS
  Facility-associated pneumonia is an important cause of morbidity and mortality in long-term care facilities.
authors.affiliation: Department of Nursing, Veterans Administration Medical Center, Canandaigua, NY 14424.
authors.forename: A M
authors.initials: AM
authors.lastname: McDonald
authors.forename: L
authors.initials: L
authors.lastname: Dietsche
authors.forename: M
authors.initials: M
authors.lastname: Litsche
authors.forename: R
authors.initials: R
authors.lastname: Spurgas
authors.forename: R
authors.initials: R
authors.lastname: Ledgerwood
authors.forename: C J
authors.initials: CJ
authors.lastname: Subitha
authors.forename: F M
authors.initials: FM
authors.lastname: LaForce
mesh_terms: D003428:Cross Infection / Q000453:epidemiology*; D006746:Hospital Bed Capacity, 500 and over; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D009518:New York / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology*; D011159:Population Surveillance; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors