A retrospective, observational study compiled data from all consecutively admitted patients older than 18 years at ICU University Hospital in Olomouc in the period from 1 January 2011 to 31 December 2015 who fulfilled the criteria of HAP. The aim was to determine the severity of the specific risk factors of early and late HAP. Risk factors were divided into factors from the patient and from the hospitalization. Furthermore, an assessment of their relationship to mortality.
The primary outcome was to evaluate the relationship between risk factors and the development of early/late onset HAP. Another outcome was assessed to evaluate the relation of risk factors early/late onset HAP and mortality. The crucial time for evaluating the presence of risk factors was their presence from hospital admission to the moment of fulfilling the criteria for pneumonia. Risk factors were divided into two groups, on factors of the patient (uncontrollable) and by the hospitalization (controllable). Factors of the patient were: gender (male/female), age at enrollment (years), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, multi-organ failure presence (MOF), hypertension, ischemic heart disease (IHD) chronic renal insufficiency (CRI), continual use of renal replacement therapy (CRRT), acute renal insufficiency (ARI), diabetes mellitus (DM), Chronical Obstructive Pulmonary Disease (COPD), immunosuppression or leukopenia \<1.5x109/l, impaired consciousness with Glasgow coma scale (GCS) \<8 tracheotomy, head trauma/neurosurgery, abdominal surgery-thoracotomy. Side factors hospitalization were: aspiration into the lungs, urgent intubation, reintubated, sedation, bronchoscopy, nasogastric intubation, enteral feeding continuously/intermittently intolerance of enteral nutrition, physiotherapy, repeated transport of the patient from the ICU, length of hospital stay, length of mechanical ventilation, 30-day mortality.
Study Type
OBSERVATIONAL
Enrollment
310
no intervention
30-day mortality (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 30 days
Duration of mechanical ventilation before onset of HAP (non modifiable HAP risk factor)
Assessment if mechanical ventilation was provided, or for how long
Time frame: 7 days
Duration of hospital stay before onset of HAP (non modifiable HAP risk factor)
Assessment if hospital stay was present, or for how long
Time frame: 7 days
Repeated transport of the patient from the ICU (non modifiable HAP risk factor)
Assessment if repeated transports were present or not
Time frame: 30 days
Implementation of physiotherapy before onset of HAP (non modifiable HAP risk factor)
Assessment if physiotherapy was provided or not
Time frame: 7 days
Intolerance of enteral nutrition before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Nasogastric intubation before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Bronchoscopy before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
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Sedation administration before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Urgent tracheal intubation before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Tracheal reintubation before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Aspiration into the lungs before onset of HAP (non modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Condition after abdominal surgery or thoracotomy before onset of HAP (modifiable HAP risk factor)
Time frame: 7 days
Condition after head trauma or neurosurgery before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Condition after tracheotomy before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Impaired consciousness with Glasgow coma scale low than 8 before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Immunosuppression or leukopenia less than 1.5x10 9/L before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Chronical Obstructive Pulmonary Disease before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Diabetes mellitus before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Acute renal insufficiency without renal replacement therapy before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Acute renal insufficiency with renal replacement therapy before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Chronic renal insufficiency before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Ischemic heart disease before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Hypertension before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days
Multi-organ failure before onset of HAP (modifiable HAP risk factor)
Yes/No assessment
Time frame: 7 days