Hospital-acquired pneumonia developed in non-intensive care units.
BACKGROUND
There are few studies about hospital-acquired pneumonia (HAP) developing in non-intensive care units (non-ICUs).


OBJECTIVE
The aim of this study was to determine the incidence rate of non-ICU HAP, the risk factors associated with mortality and the survival rates of HAP patients at 6 weeks and 1 year.


METHODS
Between March 2005 and February 2006, 154 adult patients (97 males) with HAP were prospectively evaluated. Immunocompromised patients who were developing pneumonia were excluded from the study. The HAP incidence was calculated and survival was noted at 6 weeks and 1 year later. Kaplan-Meier methods were used for survival analysis; Cox regression was used to identify the risk factors associated with HAP-induced mortality.


RESULTS
During the study, and not counting those in the ICU, 45,679 adult patients were hospitalized. Of these, 154 patients developed HAP (incidence 3.3 cases/1,000 patients). The mean age of those developing HAP was 64.53 ± 14.92 years (range 15-98). Survival rates at the 3rd, 7th, 14th, 42nd and 365th day were 91, 89, 69, 49 and 29%, respectively. Independent risk factors associated with 6-week mortality were: age [relative risk (RR) 1.026; 95% confidence interval (CI) 1.008-1.045], chronic renal failure (RR 1.8; 95% CI 1.087-3.086), aspiration risk (RR 2.86; 95% CI 1.249-6.564), steroid use (RR 2.35; 95% CI 1.306-4.257), and multilobar infiltration (RR 2.1; 95% CI 1.102-4.113).


CONCLUSIONS
HAP - even if it develops in non-ICU environments - is hard to treat and has a higher mortality rate.
Cakir Edis
Ebru
E
Department of Pulmonary Medicine, Trakya University Medical Faculty, TR-22030 Edirne, Turkey. ebruckr@yahoo.com
Hatipoglu
Osman N
ON
Yilmam
Ilker
I
Eker
Alper
A
Tansel
Ozlem
O
Sut
Necdet
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000401:mortality*; D005260:Female; D006748:Hospital Departments; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult