EPIDEMIOLOGY AND RISK-FACTORS OF PNEUMONIA IN CRITICALLY ILL PATIENTS

被引：40

作者：

MOSCONI, P ^{[1
]}

LANGER, M ^{[1
]}

CIGADA, M ^{[1
]}

MANDELLI, M ^{[1
]}

机构：

[1] MARIO NEGRI INST PHARMACOL RES,I-20157 MILAN,ITALY

来源：

EUROPEAN JOURNAL OF EPIDEMIOLOGY | 1991年 / 7卷 / 04期

关键词：

PNEUMONIA; INTENSIVE CARE UNIT; RISK FACTORS; MORTALITY;

D O I：

10.1007/BF00144995

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Risk factors for pneumonia were analysed in a large population of critically ill patients, collected in two prospective multicentre "pneumonia studies" in Italy. Twenty-three intensive care units were involved and the study time was 150 unit months. Only patients without previous pulmonary infection, with intensive care unit stay greater-than-or-equal-to 48 hours and no rapidly irreversible illness at admission were included. The incidence of pneumonia in the 1475 selected patients was 15% (220 cases). 239 patients died in ICU; the mortality rate was significantly higher in patients developing pneumonia (p < 0.0001); pneumonia was found to be an independent highly significant risk factor for death in critically ill patients (OR = 3.88; p < 0.0001). Multivariate analysis of seven risk factors for pneumonia showed a significantly higher risk in patients with neuromuscular disease (OR = 3.8, p < 0.002), impairment of airway reflexes at admission (OR = 2.93, p < 0.0001), and greater-than-or-equal-to 24h respiratory assistance (OR = 3.05, p < 0.0001). Impairment of airway reflexes at admission to the emergency room or intensive care unit identifies the population who will experience 3/4 of the overall lower respiratory tract infections. Rapid recognition of at-risk patients seems clinically important and may improve awareness programs and preventive approaches.

引用

页码：320 / 327

页数：8

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