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Published on March 1, 2013 | http://doi.org/10.5867/medwave.2013.02.5637
Risk factors and mortality from hospital acquired pneumonia in the Stroke Intensive Care Unit
Factores de riesgo y mortalidad por neumonía intrahospitalaria en la Unidad de Terapia Intensiva de Ictus
Introduction. Stroke is the third leading cause of death. Hospital acquired pneumonia is an ongoing challenge due to the current microbiological spectrum, antimicrobial resistance, high mortality and associated costs. Objetive. To describe risk factors and their relationship to hospital stay and mortality of patients admitted to the Stroke ICU with hospital acquired pneumonia from 2007 to 2009. Methods. Prospective descriptive study. Variables: age, sex, risk factors, time of onset, stay and discharge status. We used chi square (X2) of homogeneity to determine the possible association between variables and the Fisher test probabilities. Results. 61 patients developed hospital acquired pneumonia (34.07%). We found a predominance of 60-80 year-old males. Among the risk factors we found major neurological damage in 21 (34.4%), smoking in 15 (24.5%), heart failure in 11 (18.0%), diabetes mellitus in 6 (9.8%), COPD in 4 (6.5%). Mechanical ventilation was used in 14 (38.4%), endotracheal intubation in 16 (29.2%), prolonged bedridden condition in 11 (18%) and nasogastric tube placement in 7 (11.5%). The infection appeared between the third and sixth day in 57.4%; hospital stay was prolonged in 54% and 25 patients died (40.92%). Conclusions. Hospital acquired pneumonia was more common patients with mechanical ventilation, which prolonged stay and increased mortality. The microbiological environment was dominated by Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumanni.