Factors Affecting Poor Outcomes in Hospital-Acquired Pneumonia Patients Followed in the Intensive Care Unit: A Retrospective Cohort Study
Abstract
Purpose: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health problems worldwide. The aim of this study was to determine the etiological pathogens, susceptibility distribution, and parameters that may indicate poor prognosis in patients diagnosed with HAP/VAP and followed up in the intensive care unit (ICU).
Materyal-Metod: This study was designed as a retrospective cohort study. Demographic characteristics, causative microorganisms, susceptibility profiles of these pathogens, and 28-day mortality data (all-cause) of patients diagnosed with HAP and VAP who were hospitalized in the ICU were retrospectively reviewed from patient files. At the end of the 28-day period, patients were divided into survivor and non-survivor groups based on their survival status. Clinical parameters were compared between the two groups.
Results: This study included 142 patients diagnosed with HAP who were followed up at ICU. Of these, 102 (71.8%) patients were diagnosed with ventilator-associated pneumonia (VAP). The median age of the cohort was 72 years (IQR: 65–79), and 73.9% were male. The frequency of concomitant malignancy (43.0% vs 25.0%, p=0.029), WBC values at the onset of pneumonia [median 15.2 (IQR: 9.8–20.9) vs 11.9 (IQR: 8.6–14.4), p=0.010], procalcitonin levels [median 0.9 [(IQR: 0.3–5.3) vs 0.3 (IQR: 0.1–1.4) p=0.003], and the frequency of bacteremia secondary to pneumonia (39.5% vs 8.9% p
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