Characteristics and Risk Factors of Severe Hospital Acquired Pneumonia Combined with Acute Cerebrovascular Diseases
WANG Ben-Guo;YANG Nan;ZENG Jing;et al.
2010, 5(11):
894-898.
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Objective To investigate and analyze the characteristics and risk factors of severe hospitalacquires pneumonia (SHAP).Methods A retrospective analysis was designed. The study group was the patients who wereconsidered as severe hospital acquired pneumonia, the control group was the patients withcommon hospital acquired pneumonia (CHAP). The characteristics and risk factors wereanalyzed and compared.Results The incidence of hospital acquired pneumonia (HAP) in neurology department was7.5%, the incidence of SHAP was 0.8%, the ratio of SHAP to HAP was 10.6%. Compared withCHAP, SHAP group had a higher rate of COPD (26.1% to 21%, P <0.05), a higher rate of heartfailure (34.8% to 19.0%, P <0.05), a higher NIHSS (14.3±5.4 to 6.7±3.2, P <0.05), a higher rateof alteration of consciousness (52.2% to 16.4%, P <0.01), a higher rate of swallowing disorder(56.5% to 25.1%, P <0.01), a higher rate of bilateral pneumonia (47.8% to 23.6%, P <0.05) and ahigher rate of hypoproteinemia (56.5% to 20.0%, P <0.01). The SHAP group had a more chancesto administrate sedative therapy (73.9% to 28.7%, P <0.01) and gastric acid-suppressive therapy(91.3% to 35.9%, P <0.01). The SHAP group had a higher utilization rate of urinary catheterintubation (82.6% to 28.7%, P <0.01), nasogastric tube feeding (65.2% to 21%, P <0.01) and centralvenous catheter procedure (73.9% to 28.7%, P <0.01). The value of CRP of SHAP was higher (34.6±7.4 to 9.6±7.4 mg/L, P <0.01). The median hospital stay of SHAP was longer and the cost ofhospitalization was higher. The mRS at discharge of SHAP and the mortality were both highercompared with HAP group.Conclusion Severe hospital acquired pneumonia is one of the most serious complicationsassociated with acute cerebrovascular diseases in neurology department. SHAP is statisticallyassociated with the severity of acute cerebrovascular diseases and has many risk factors withhigher mortality and high levels of disability. Increased attention should be paid to improve ourknowledge about SHAP associated with acute stroke.
