Impact of hospital-acquired pneumonia on rehabilitation outcomes and mortality in patients after severe acquired brain injury: a retrospective cohort study
Abstract
Background Patients after severe acquired brain injury (sABI) have an increased susceptibility to systemic infections, which can severely compromise their rehabilitation process. In this study, we aimed to evaluate the impact of hospital-acquired pneumonia (HAP) on functional outcome and mortality in a large cohort of adult patients underwent inpatient rehabilitation from post-acute to 6 months after sABI. Methods This observational retrospective cohort study included patients consecutively admitted after an acute sABI to Neurorehabilitation Unit for 6-month program between December 1, 2019, and December 31, 2022. Demographic data, etiology of sABI (traumatic vs. non-traumatic), length of stay, comorbidities, neurological impairment, presence of invasive devices (tracheostomy and nasogastric tube, percutaneous endoscopic gastrostomy), occurrence of HAP, and death during hospitalization were recorded. Functional assessments were evaluated at admission and discharge with the Functional Independence Measure (FIM), the Levels of Cognitive Functioning (LCF), and the Glasgow Outcome Scale-extended (GOS-E). Results Of the 169 patients enrolled, 78 (46.2%) developed HAP during hospitalization. Of the 169 patients enrolled, 78 (46.2%) developed HAP during hospitalization. The multivariable logistic regression analysis identified as significant risk factors for the onset of HAP during hospitalization male sex (OR 0.313, p = 0.003), severity of brain injury (OR 0.825, p = 0.011), and…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 169 participants or records.
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