[Risk factors for the development of pneumonia in multiple injured patients. Results of a prospective clinical trial].
Pneumonia is the most common infectious complication in multiple trauma patients. In a prospective clinical cohort study, 266 multiply injured patients were examined for the development of pneumonia. Various risk factors were tested in uni- and multivariate analyses. Three different definitions of pneumonia were used in order to examine how results depended on definition. The incidence of pneumonia was 41%, but varied with definition (30-50%). Injuries to the thorax, head,and abdomen were associated with a significantly increased risk of pneumonia (adjusted relative risk: 1.77, 1.97,and 1.52, respectively).Furthermore, increasing age led to a higher risk of pneumonia. Although the primary analysis revealed a higher pneumonia risk in male patients (adjusted relative risk: 2.23; 95% CI: 1.43-3.05), this result could not be consistently reproduced when using other definitions of pneumonia. Trunk and head injuries and age are proven risk factors for developing posttraumatic pneumonia. The association between male gender and an increased rate of infectious complications remained questionable.
Klinik und Poliklinik für Unfall- Hand- und Wiederherstellungschirurgie, Klinikum der Universität zu Köln, Cologne. jandermahr@t-online.de
J
J
Andermahr
T
T
Hensler
S
S
Sauerland
A
A
Greb
H-J
HJ
Helling
A
A
Prokop
E A M
EA
Neugebauer
K E
KE
Rehm
D015998:Abbreviated Injury Scale; D000328:Adult; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D018410:Pneumonia, Bacterial / Q000209:etiology*; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013898:Thoracic Injuries / Q000150:complications