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Báo cáo y học: " Impact of nosocomial pneumonia on the outcome of mechanically-ventilated patient

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Impact of nosocomial pneumonia on the outcome of mechanically-ventilated patients. | Available online http ccforum.eom content 2 1 19 Research Impact of nosocomial pneumonia on the outcome of mechanically-ventilated patients J Solé Violán C Sanchez-Ramirez A Padrón Mújica JA Cardenosa Cendrero J Arroyo Fernandez and F Rodríguez de Castro Unidad de Medicina Intensiva Hospital Ntra Sra del Pino Angel Guimerá 93 35005 Las Palmas de Gran Canaria Spain. Received 20 June 1 997 Revisions requested 27 August 1997 Revisions received 18 September 1997 Accepted 13 January 1998 Published 12 March 1998 1998 Current Science Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Crit Care 1998 2 19 Background Nosocomial pneumonia NP is a common complication in mechanically-ventilated patients and is considered to be one of the most common causes of morbidity and mortality. However assessment of the associated mortality is not staightforward as it shares several risk factors with NP that confound the relationship. The aim of this study was to evaluate the impact of NP on the mortality rate in an intensive care unit. During the study period January-December 1995 all patients under mechanical ventilation for a period 48 h n 314 were prospectively evaluated and the prognostic factors of NP which have been identified in previous studies were recorded. Results Pneumonia was diagnosed in 82 patients. The overall mortality rate was 34 for patients with NP compared to 17 in those without NP. Multivariate analysis selected the following three prognostic factors as being significantly associated with a higher risk of death the presence of multiple organ failure odds ratio Or 6.71 95 CI P 0.001 the presence of adult respiratory distress syndrome ARDS OR 3.03 95 CI P 0.01 and simplified acute physiology score SAPS 9 Or 2.89 95 CI P 0.05 . Conclusions In mechanically-ventilated patients NP does not represent an independent risk factor for mortality. Markers of severity of illness were the strongest predictors for mortality. Keywords mechanical ventilation mortality nosocomial .