Pneumonia in patients with severe head injury: incidence, risk factors, and outcomes

Author:

Wang Kuo-Wei1,Chen Han-Jung1,Lu Kang1,Liliang Po-Chou1,Huang Chun-Kai2,Tang Pi-Lien3,Tsai Yu-Duan1,Wang Hao-Kuang1,Liang Cheng-Loong1

Affiliation:

1. Departments of Neurosurgery and

2. Infection, E-Da Hospital, I-Shou University; and

3. Department of Nursing, Fooyin University Hospital, Kaohsiung, Taiwan

Abstract

Object The reported incidence of hospital-acquired bacterial pneumonia in critically ill trauma patients varies from as low as 4% to as high as 87%, with fatality rates varying from 6% to 59%. Clinical studies have identified the risk factors for pneumonia. The authors undertook this retrospective study to evaluate the incidence, risk factors, and outcomes of hospital-acquired bacterial pneumonia in a group of patients with severe head injuries. Methods This was a retrospective review of consecutive adult patients admitted to the neurosurgical ICU in the authors' hospital because of severe head injury (Glasgow Coma Scale scores ≤ 8) between January 2008 and December 2010. Results During the study period, 290 patients were admitted to the neurosurgical ICU. Multivariate Cox regression analysis showed that age (HR 1.01, 95% CI 1.001–1.02), nasogastric tube insertion (HR 4.56, 95% CI 1.11–18.64), and hemiplegia or hemiparesis (HR 3.79, 95% CI 2.01–7.17) were significantly associated with the development of pneumonia. Conclusions The authors identified 3 risk factors (age, nasogastric tube insertion, and hemiplegia or hemiparesis) associated with the development of pneumonia in patients with severe head injury. This finding constituted the basis for developing a simple screening tool that can be used to assess the risk of occurrence of pneumonia in such patients.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Genetics,Animal Science and Zoology

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