Predictors of Nosocomial Pneumonia in Trauma Patients


Name: Janet Harris

Rank: LTC, USA

Organization: Henry M. Jackson Foundation

Performance Site: R. A. Cowley Shock Trauma, University of Maryland Medical System, Baltimore, MD

Year Published: 1997

Abstract Status: Final


The purposes of this study are to 1) to examine the structure of constructs underlying risk factors that increase the risk of nosocomial pneumonia; 2) identify predictors of nosocomial pneumonia in critically ill trauma patients; and 3) explore if there are different predictive models for early onset (< 5 days) and late onset (> 5 days) nosocomial pneumonia. Nosocomial pneumonia is the most common pulmonary complication in trauma patients and is associated with increased hospital costs, mortality, and morbidity. The pneumonia theoretical framework utilized by the Centers for Disease Control guided the selection of risk factors. Design: A prospective cohort study of 600 consecutive critically ill trauma patients will evaluate 19 risk factors (age, Glasgow Coma Score, Injury Severity Score, Abbreviated Injury Score (AIS) of the head region, AIS of the chest region, hypotension, intracranial pressure monitoring, COPD, head surgery, thoracic/upper abdominal surgery, antibiotics, gastric acid inhibitors, enteral feedings, nasogastric tube, intubation, duration of mechanical ventilation, days of bed rest, integrity of the endotracheal tube cuff, and supine positioning) for nosocomial pneumonia. Analysis: Descriptive statistics will be used for demographics and to summarize risk factors. Confirmatory factory analysis with LISREL 8 will be utilized to examine the factor structure of constructs underlying risk factors for pneumonia. Logistic regression will be utilized to develop a predictive model for nosocomial pneumonia. Predictive models will be developed for both early onset and late onset pneumonia. Significance: Developing a predictive model for pneumonia will allow early identification of patients at risk of acquiring pneumonia so the practitioner can implement preventive measures. Identification of risk factors for pneumonia will aid the development of a clinical tool for assessing a patient's risk of pneumonia on admission. Additionally, identification of risk factors for nosocomial pneumonia is necessary to allow the researcher to control confounding variables during intervention studies.


Final Report is available on NTRL: