Risk Factors and Markers of Severity in Hospital Acquired Pneumonia

Title: Risk Factors and Markers of Severity in Hospital Acquired Pneumonia
Author(s): Bright. C1, Leahy. D2, Linnane. S2
Institution: University College Dublin, School of Medicine and The Beacon Hospital
Poster: Click to view poster
Category: CF and Pulmonary Infections
Abstract: Hospital-acquired pneumonia (HAP) is a nosocomial infection occurring in hospital patients >72 hours post admission. Studies on hospital pneumonia tend to focus on ventilator associated infections meaning that HAP is a neglected area of research. HAP is an avoidable cause of morbidity and mortality with a concomitant impact on health economics.
A clinical audit took place in the Beacon Hospital in order to identify potential risk factors and markers of severity.
The Hospital database was searched for key terms consistent with a diagnosis of HAP. 915 patients were identified. These records were individually reviewed for clinical criteria consistent with HAP. 70 patients aged (Mean (SD)) 69.9 (13.4) years fit the criteria.
Risk factors for HAP included proton-pump inhibitor use on admission (56%), cardiothoracic surgery (31%), low haemoglobin levels on admission (59%) and presence of active cancer (33%). Adverse outcomes were more common in those with elevated white cell count and C-reactive protein levels, as well as low albumin (p = 0.04) or haemoglobin levels (p = 0.04 ANOVA).
This audit indicates that HAP is a significant clinical problem. Several risk factors and routine blood tests may allow earlier identification of at-risk patients improving both morbidity and mortality.