title: Predictors of nosocomial pneumonia in intracerebral hemorrhage patients: a multi-center observational study.
abstract: BACKGROUND
  Nosocomial pneumonia (NP) is a frequent complication among spontaneous intracerebral hemorrhage (sICH) patients. This study was aimed at identifying in-hospital risk factors that predispose sICH patients to NP.
  
  
  METHODS
  We identified 591 consecutive sICH subjects admitted to six tertiary care hospitals between 2008 and 2012. Information regarding patients' demographics, admission data, laboratory tests, medical history, diagnostic imaging, in-hospital treatments, complications, and outcomes were collected. Using a competing risks analysis, we assessed risk factors associated with NP.
  
  
  RESULTS
  Mean age of the subjects was 68 years; 51 % were female and 76 % were white. One-hundred sixteen (19.6 %) of the sICH patients had NP. In the univariate analysis, variables including age, non-white race, early hospital admission (<6 h after onset), larger hematoma volume, basal ganglia or intraventricular hemorrhage, multisite hemorrhage, in-hospital aspiration, intubation, nasogastric tube placement, hematoma evacuation, high ICH score, ventricular drainage, and tracheostomy had a positive association with NP. However, in the multivariate analysis, only early hospital admission, in-hospital aspiration, intubation, and tracheostomy remained statistically significant predictors (p < 0.05). For patients who survived hospitalization, the median length-of-stay (LOS) with or without NP was 20.0 and 4.0 days, respectively (p < 0.0001). For patients who did not survive to discharge, the median LOS with or without NP was 10.5 and 2.0 days, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Independent predictors of NP included early hospital admission, in-hospital aspiration, intubation, and tracheostomy. NP was associated with prolonged hospital LOS.
authors.affiliation: Department of Neurology, University of Minnesota, 420 Delaware Street SE, MMC 295, Minneapolis, MN, USA, divani@umn.edu.
authors.forename: Afshin A
authors.initials: AA
authors.lastname: Divani
authors.forename: Mario
authors.initials: M
authors.lastname: Hevesi
authors.forename: Swaroopa
authors.initials: S
authors.lastname: Pulivarthi
authors.forename: Xianghua
authors.initials: X
authors.lastname: Luo
authors.forename: Fotis
authors.initials: F
authors.lastname: Souslian
authors.forename: Jose I
authors.initials: JI
authors.lastname: Suarez
authors.forename: Eric M
authors.initials: EM
authors.lastname: Bershad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007440:Intubation / Q000009:adverse effects / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014139:Tracheostomy / Q000009:adverse effects / Q000706:statistics & numerical data*