Predictors of nosocomial pneumonia in intracerebral hemorrhage patients: a multi-center observational study.

Abstract:

BACKGROUND:Nosocomial pneumonia (NP) is a frequent complication among spontaneous intracerebral hemorrhage (sICH) patients. This study was aimed at identifying in-hospital risk factors that predispose sICH patients to NP. METHODS:We identified 591 consecutive sICH subjects admitted to six tertiary care hospitals between 2008 and 2012. Information regarding patients' demographics, admission data, laboratory tests, medical history, diagnostic imaging, in-hospital treatments, complications, and outcomes were collected. Using a competing risks analysis, we assessed risk factors associated with NP. RESULTS:Mean age of the subjects was 68 years; 51 % were female and 76 % were white. One-hundred sixteen (19.6 %) of the sICH patients had NP. In the univariate analysis, variables including age, non-white race, early hospital admission (<6 h after onset), larger hematoma volume, basal ganglia or intraventricular hemorrhage, multisite hemorrhage, in-hospital aspiration, intubation, nasogastric tube placement, hematoma evacuation, high ICH score, ventricular drainage, and tracheostomy had a positive association with NP. However, in the multivariate analysis, only early hospital admission, in-hospital aspiration, intubation, and tracheostomy remained statistically significant predictors (p < 0.05). For patients who survived hospitalization, the median length-of-stay (LOS) with or without NP was 20.0 and 4.0 days, respectively (p < 0.0001). For patients who did not survive to discharge, the median LOS with or without NP was 10.5 and 2.0 days, respectively (p < 0.001). CONCLUSIONS:Independent predictors of NP included early hospital admission, in-hospital aspiration, intubation, and tracheostomy. NP was associated with prolonged hospital LOS.

journal_name

Neurocrit Care

journal_title

Neurocritical care

authors

Divani AA,Hevesi M,Pulivarthi S,Luo X,Souslian F,Suarez JI,Bershad EM

doi

10.1007/s12028-014-0065-x

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

234-42

issue

2

eissn

1541-6933

issn

1556-0961

journal_volume

22

pub_type

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