title: Factors associated with pneumonia in post-cardiac arrest patients receiving therapeutic hypothermia.
abstract: OBJECTIVE
  The aim of this study is to investigate risk factors associated with the development of pneumonia during the first 7 days of admission in survivors of cardiac arrest receiving therapeutic hypothermia.
  
  
  METHODS
  A total of 123 patients receiving therapeutic hypothermia after out-of-hospital cardiac arrest between January 2008 and December 2010 were enrolled. Study populations were categorized as "pneumonia present" [P (+)] and "pneumonia absent" [P (-)] contingent upon the development of pneumonia during the first 7 days of admission. Risk factors and outcomes related to development of pneumonia were determined.
  
  
  RESULTS
  Fifty-nine patients (48.0 %) developed pneumonia, and P (+) patients had lower Acute Physiology and Chronic Health Evaluation II score (22 vs 26); longer durations of central venous catheter (8.9 vs 5.1 days), nasogastric tube (11.1 vs 3.8 days), mechanical ventilation (MV) (9.3 vs 3.7 days), and intensive care unit stay (10.0 vs 5.0 days); and higher rates of nasogastric feeding (66.1% vs 35.9 %), tracheostomy (52.5% vs 17.2 %), and postanoxic seizure (62.7% vs 39.1 %). In multivariate analyses, the occurrence of postanoxic seizure (odds ratio, 2.75; 95% confidence interval, 1.06-7.14; P = .04) and the length of MV (odds ratio, 1.33; 95% confidence interval, 1.15-1.52; P < .001) were independently associated with the development of pneumonia. The development of pneumonia had no significant association with survival (log-rank test, P = .15).
  
  
  CONCLUSIONS
  Postanoxic seizure and prolonged duration of MV are independently associated with development of pneumonia. It may be helpful that we give more attention to the development of pneumonia in patients with postanoxic seizure and provide prompt diagnosis and treatment of postanoxic seizure.
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Jae-Hyug
authors.initials: JH
authors.lastname: Woo
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea. Electronic address: yongem@gmail.com.
authors.forename: Yong Su
authors.initials: YS
authors.lastname: Lim
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Hyuk Jun
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Won Bin
authors.initials: WB
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Jin Seong
authors.initials: JS
authors.lastname: Cho
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Jin Joo
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Sung Youl
authors.initials: SY
authors.lastname: Hyun
authors.affiliation: Department of Emergency Medicine, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors.forename: Gun
authors.initials: G
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000628:therapy*; D018410:Pneumonia, Bacterial / Q000209:etiology* / Q000382:microbiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome