Incidence and potential risk factors for hospital-acquired pneumonia in an emergency department of surgery.
OBJECTIVE
Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma.


METHODS
A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group. Ten variables judged as potential risk factors for HAP were studied in 90 patients.


METHODS
An emergency ward for surgical patients with acute abdomen or trauma at an Univerity hospital in Sweden.


METHODS
A total of 90 patients with HAP and 120 age-matched controls were included.


METHODS
Risk factors for HAP in patients at a surgical clinic.


RESULTS
Of a total of 10 335 admitted patients, during 4.5 years the hospital stay was longer than 48 h in 4961 patients. Of these 90 (1.8%) fulfilled the strict criteria for HAP. Potential risk factors were suspected or verified aspiration (odds ratio (OR): 23.9) that was 2-fold higher than immobilization (OR: 11.2). Further, chronic pulmonary obstructive disease (COPD)/asthma, abdominal surgery and gastric retention/vomiting were risk factors for HAP.


CONCLUSIONS
Verified or suspected aspiration was the dominating risk factor for HAP but also immobilization was frequently associated with HAP. Various established preventive measures should be implemented in the nursing care to reduce the frequency of HAP.
Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Marie
M
Stenlund
Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.|Development and Patient Safety Unit, Linköping University, Linköping, Sweden.
Rune
R
Sjödahl
Research and Development Unit in Local Health Care, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
R N
RN
Pia Yngman-Uhlin
D000006:Abdomen, Acute / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014947:Wounds and Injuries / Q000601:surgery*
advanced nursing; hospital-acquired pneumonia; nursing intervention; prevention, surgery