Stenlund Marie, Sjödahl Rune, Pia Yngman-Uhlin R N
Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Development and Patient Safety Unit, Linköping University, Linköping, Sweden.
Int J Qual Health Care. 2017 Apr 1;29(2):290-294. doi: 10.1093/intqhc/mzx018.
Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma.
A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group. Ten variables judged as potential risk factors for HAP were studied in 90 patients.
An emergency ward for surgical patients with acute abdomen or trauma at an Univerity hospital in Sweden.
A total of 90 patients with HAP and 120 age-matched controls were included.
Risk factors for HAP in patients at a surgical clinic.
Of a total of 10 335 admitted patients, during 4.5 years the hospital stay was longer than 48 h in 4961 patients. Of these 90 (1.8%) fulfilled the strict criteria for HAP. Potential risk factors were suspected or verified aspiration (odds ratio (OR): 23.9) that was 2-fold higher than immobilization (OR: 11.2). Further, chronic pulmonary obstructive disease (COPD)/asthma, abdominal surgery and gastric retention/vomiting were risk factors for HAP.
Verified or suspected aspiration was the dominating risk factor for HAP but also immobilization was frequently associated with HAP. Various established preventive measures should be implemented in the nursing care to reduce the frequency of HAP.
医院获得性肺炎（HAP）与高死亡率相关，是第二常见的医院感染。本研究的目的是计算瑞典一所大学医院急诊病房中因急腹症或创伤入院的外科患者发生HAP的发病率，并确定其潜在危险因素。
对病历进行结构化回顾。将入院48小时后被诊断为肺炎的患者与随机选择的年龄匹配对照组进行比较。在90名患者中研究了10个被判定为HAP潜在危险因素的变量。
瑞典一所大学医院中因急腹症或创伤入院的外科患者急诊病房。
共纳入90例HAP患者和120例年龄匹配的对照。
外科门诊患者发生HAP的危险因素。
在总共10335例入院患者中，4.5年间有4961例患者住院时间超过48小时。其中90例（1.8%）符合HAP的严格标准。潜在危险因素包括疑似或证实的误吸（优势比（OR）：23.9），其比制动（OR：11.2）高2倍。此外，慢性阻塞性肺疾病（COPD）/哮喘、腹部手术和胃潴留/呕吐也是HAP的危险因素。
证实或疑似的误吸是HAP的主要危险因素，但制动也常与HAP相关。护理中应实施各种既定的预防措施以降低HAP的发生率。
