[Risk factors and prognostic factors in nosocomial pneumonia outside the intensive care units setting].
BACKGROUND
Nosocomial pneumonia (NP) is the second most frequent cause of hospital-acquired infection and is associated with elevated morbidity and mortality rates, particularly in intensive care units (ICU). The objectives of this study were to determine the incidence, risk factors and prognostic factors of NP acquired outside the ICU.


METHODS
A prospective case-control study was performed. All NP cases were acquired outside the ICU, and each case was paired with a control subject matched for gender, age, date of admission and hospitalization area. Epidemiological, clinical and microbiological data were obtained from cases and controls, and the risk factors and prognostic factors for NP were established.


RESULTS
During the study period a total of 67 cases of NP outside the ICU were diagnosed. Estimated incidence was 3.35 cases/1,000 admissions. Mean age of the patients was 70 +/- 13 years and 48 of them were men. On multivariate analysis adjusted for confounding factors, bronchoaspiration, previous surgery and steroids were significantly associated with the development of NP. Mortality attributable to NP was 27%. The existence of an ultimately or rapidly fatal underlying condition and the presence of leukocytosis or leukopenia were associated with poor prognosis.


CONCLUSIONS
The incidence of NP outside the ICU setting is low. Measures to reduce bronchoaspiration and judicial steroid use are necessary to decrease the risk of acquiring NP and to improve the prognosis.
Barreiro-López
Bienvenido
B
Servicio de Neumología, Hospital Mútua de Terrassa, Universidad de Barcelona, Spain. bienvebarreiro@comb.es
Tricas
Josep Maria
JM
Mauri
Elisabeth
E
Quintana
Salvador
S
Garau
Javier
J
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology*; D004198:Disease Susceptibility; D005260:Female; D006748:Hospital Departments; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000453:epidemiology; D018410:Pneumonia, Bacterial / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents