[The annual incidence and mortality associated with hospital infections of the lower respiratory tract in a regional hospital].

BASIR. The incidence and the associated mortality to lower respiratory tract nosocomial infections (LRTI) were studied in a small regional hospital to evaluate if the different structural complexity of hospitals has some repercussions on the morbidity and the mortality of those infections. MATERIAL AND METHODS. The study was carried out in Calatayud hospital, a small regional hospital of 122 beds belonging to Health Area III of Aragón. All LRTI that occurred during 1992 were recorded by means of a prospective surveillance system based on a daily revision of hospital medical records. The accumulated incidence of LRTI (AI-LRTI), the accumulated incidence of infected patients (AIIP) and the associated mortality rate (AMR) were used as morbidity and mortality indicators of LRTI. The relative effect of the exposition to some variables on morbidity and mortality was estimated by means of the odds ratio (OR). RESULTS. Altogether, 64 LRTI were detected in 63 patients during the period of study, accounting for 21% of all nosocomial infections of the whole year and supposing an AI-LRTI and an AI IP of 1.5 cases per 100 patients admissions. The incidence was bigger in males (OR = 1.7), in older than 70 years (OR = 3.7) and in patients that were admitted in services of general surgery (AI-LRTI = 3.8%) and traumatology (AI-LRTI = 2.1%). The AMR to LRTI was 24%, accounting for 12% of hospital global mortality during that year. CONCLUSIONS. Results point out that LRTI could be an important cause of nosocomial morbidity and associated mortality also in small hospitals. It would be required that in this sort of centers, depending of the more frequent kind of LRTI, suitable precautions were adopted systematically to avoid as far as possible the emergence of LRTI and their negatives consequences.