Incidence, risk factors and prognosis of nosocomial pneumonia in adult patients admitted in the intensive care unit

Abstract

Introduction: Hospital acquired pneumonia (HAP) is the second most commonly reported hospital infection and the most common infection in the intensive care unit (ICU). Identification of risk factors and determinants of prognosis in the occurrence of HAP and ways of prevention can be effective in reducing the incidence and mortality of these infections. In this way, we investigated, the incidence of HAP, its prognostic risk factors in adult patients admitted in intensive care unit of the Kosar Hospital in Semnan, Iran. Materials and Methods: In this cross-sectional study, 283 patients over 18 years of age hospitalized in intensive care units of Kosar Hospital, Semnan, Iran during the period of 2018 years with the inclusion criteria for pneumonia were studied. Patients who were infected with infectious diseases at the time of admission to ICU and Patients who died or were discharged before 48 hours were excluded. Results: 59% of patients were male. The mean ± SD age of the patients was 64.3 ±20.0 (18 to 96 years). 8.5% had abdominal surgery, 6.7% chest surgery, 27.2% diabetes and 38.9% had high blood pressure.15.9% ( 95%CI:11.720.1%) were infected with pneumonia. Interestingly, Pneumonia was not associated with age, abdominal surgery, chest surgery, diabetes, and high blood pressure. The duration of having a nasogastric tube (P<0.001) and connection to ventilator was significantly higher in patients with pneumonia (P<0.001). Overall mortality in patients was 53.4%. Mortality rate was 73.3% in patients with pneumonia and 49.6% in patients without pneumonia, and this difference was significant (P=0.003). 62% of patients, with NG tube and 22.6% of patients, without NG tube died and this difference was significant (P<0.001). Increasing age also increases the risk of death (P<0.001). Conclusion: The findings indicate a high incidence of pneumonia and mortality in hospitalized patients, which has a direct relation with the duration of the nasogastric tube, the connection to the ventilator and age. Therefore, special attention to such patients, especially older patients, is necessary to reduce the duration of nasogastric tube and connection to ventilator.