[Risk factors associated with the presence of pneumonia in patients with brain injury].
BACKGROUND
Pneumonia in patients with head trauma occurs commonly; however, few data are available to evaluate the effects of the infection on the prognosis.


OBJECTIVE
The incidence and microbiological findings were described, and the associated risk factors were established with the appearance of pneumonia in patients with severe brain trauma.


METHODS
A prospective cohort study was conducted that included 39 patients with severe brain trauma and who required mechanical ventilation; initially, none had pneumonia. These patients were observed during a 24-month period in an attempt to discern the principal risk factors associated with the onset of pneumonia.


RESULTS
Pneumonia occurred in 31 (80%) of the 39 patients, and 28 of these presented early pneumonia. The most frequent germ in patients with pneumonia was Staphylococcus aureus with a percentage of the 42.4%. In the multivariate analysis, the single statistically significant risk factor was the presence of hypotension and vasopressor support with a RR = 27.9 (95% CI = 1.0-749.9, p < 0.05). No significant differences in the days of mechanical ventilation or mortality in both groups. The major mortality-associated risk factor in patients with pneumonia was a low Glasgow score at admittance with an OR = 2.19 (95% CI 1.03 - 4.65), p < 0.05.


CONCLUSIONS
The incidence of pneumonia in patients with severe brain trauma is high; however, its appearance does not affect the prognosis. The single significant risk factor was the presence of hypotension and vasopressor support.
Yepes
David
D
Departamento de Cuidado Intensivo, Clinica Bolivariana, Medellín, Colombia. dyepesmx@yahoo.com.mx
Molina
Francisco
F
Ortiz
Gloria
G
Aguirre
Ricardo
R
D018806:APACHE; D000328:Adult; D001463:Barbiturates / Q000627:therapeutic use; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D011023:Pneumonia, Staphylococcal / Q000453:epidemiology / Q000209:etiology; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D055815:Young Adult
D001463:Barbiturates; D014662:Vasoconstrictor Agents