Risk factors for nosocomial pneumonia after coronary artery bypass graft operations.
We attempted to determine risk factors for nosocomial pneumonia in patients undergoing a coronary artery bypass graft operation. We reviewed the microbiology and medical records for any patient with a sputum culture who had undergone a coronary artery bypass graft operation in 1988 to identify patients with pneumonia according to a standard clinical definition. We found 19 cases of pneumonia through our initial review; complete medical records were found on 15 cases. Gram-negative bacilli predominated as the most common etiologic agent causing pneumonia in this cohort. There were no clusters noted. Mortality was 26.6%. Pneumonia occurred approximately 4 days after the operation. Thirty-six controls were randomly selected from patients undergoing coronary artery bypass graft operations in 1988. Logistic regression analysis revealed that a history of chronic obstructive lung disease, duration of more than 2 days of mechanical ventilation after operation but before diagnosis of pneumonia, and receipt of gastric acid inhibitors (antacids or H2-blockers) were independent risk factors for nosocomial pneumonia. Only the last risk factor was amenable to intervention at the time of operation.
Gaynes
R
R
Department of Internal Medicine, University of Michigan Hospitals, Ann Arbor.
Bizek
B
B
Mowry-Hanley
J
J
Kirsh
M
M
D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006635:Histamine H2 Antagonists / Q000009:adverse effects; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000009:adverse effects; D012307:Risk Factors; D015996:Survival Rate
D006635:Histamine H2 Antagonists