Document Detail


Incidence and risk factors of pneumonia acquired in intensive care units. Results from a multicenter prospective study on 996 patients. European Cooperative Group on Nosocomial Pneumonia.
MedLine Citation:
PMID:  8408934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the incidence of pneumonia acquired in the intensive care unit (ICU), and to define risk factors for developing such an event. DESIGN: European prospective survey, in which all patients admitted to the participating ICU from January, 17 to 23, 1990, were followed until ICU discharge. SETTING: 107 general ICUs from 18 countries. PATIENTS: Of 1078 admitted to the ICUs, 996 patients without pneumonia at admission were studied. MEASUREMENTS: Pneumonia was diagnosed by the staff physician on the basis of clinical, radiological and microbiological criteria, secondly validated by an expert committee who reviewed all the forms and even recontacted ICU physicians. Crude incidence and time to occurrence of pneumonia were estimated, then both used as end-points for prognosis analysis. RESULTS: 89 pneumoniae were observed: crude incidence was estimated at 8.9% 7-day and 14-day pneumonia rates at 15.8% and 23.4%, respectively. The risk of developing pneumonia increased when either coma, trauma, respiratory support, Apache II > 16 and/or imparied air-way reflexes were present at ICU admission. To predict time to occurrence of pneumonia, only two variables remained significant: the presence of impaired airway reflexes at admission and the use of mechanical ventilation during ICU course. CONCLUSIONS: The role of the injury to the respiratory system-with the subsequent need for respiratory support--appears central in determining the risk to acquire pneumonia in ICU. In the future, the predictive value of severity scores during ICU course should be otherwise assessed.
Authors:
S Chevret; M Hemmer; J Carlet; M Langer
Related Documents :
17483054 - Outcome and prognostic factors in patients with hematologic malignancies admitted to th...
12231494 - Outcome of patients with idiopathic pulmonary fibrosis admitted to the intensive care u...
23441974 - Real-world treatment pattern and outcomes among patients who took tapentadol ir or oxyc...
12605944 - Predictive accuracy of severity scoring system: a prospective cohort study using apache...
21939844 - Thalamic stimulation for epilepsy.
7755194 - Determinants of emergency department procedure- and condition-specific universal (barri...
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Intensive care medicine     Volume:  19     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1993  
Date Detail:
Created Date:  1993-11-19     Completed Date:  1993-11-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  256-64     Citation Subset:  IM    
Affiliation:
Département de Biostatistique et Informatique Médicale, Hôpital Saint-Louis, Paris, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coma / epidemiology
Comorbidity
Cough
Cross Infection / diagnosis,  epidemiology*,  etiology,  microbiology
Europe / epidemiology
Female
Humans
Incidence
Intensive Care Units
Male
Middle Aged
Multiple Trauma / epidemiology
Pneumonia / diagnosis,  epidemiology*,  etiology,  microbiology
Prognosis
Prospective Studies
Respiration, Artificial / adverse effects
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Respiratory response to salbutamol (albuterol) in ventilator-dependent infants with chronic lung dis...
Next Document:  Importance of pre-existing co-morbidities for prognosis of septicemia in critically ill patients.