Evidence map›Paper›PMID 39729124›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Identifying predictors of nosocomial pneumonia in trauma patients admitted to a level-1 trauma center.

T Kobes, A A R Sweet, F F A IJpma, L P H Leenen, R M Houwert, K J P van Wessem, R H H Groenwold, M C P M van Baal

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Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

T KobesDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. t.kobes-2@umcutrecht.nl.ORCID http://orcid.org/0000-0003-4618-3714
A A R SweetDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0003-2061-6403
F F A IJpmaDepartment of Trauma Surgery, University Medical Center Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-9420-2732
L P H LeenenDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0001-8385-1801
R M HouwertDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0003-3497-659X
K J P van WessemDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0002-1166-0990
R H H GroenwoldDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.ORCID http://orcid.org/0000-0001-9238-6999
M C P M van BaalDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. m.c.p.vanbaal-5@umcutrecht.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNosocomial pneumonia is common in trauma patients and associated with an adverse prognosis. We recently externally validated and recalibrated an existing formula to predict nosocomial pneumonia risk. Identifying more potential predictors could aid in a more accurate prediction of nosocomial pneumonia risk in level-1 trauma patients. This study aims to identify predictors of nosocomial pneumonia in level-1 trauma patients available in the emergency department or shortly after, and examine their added predictive value to an existing prediction model by Croce.

methodsThis retrospective cohort study included all consecutive trauma patients (≥ 16 years) admitted for > 24 h to our level-1 trauma center in 2017. Excluded were patients with active infection upon admission, transfer from another hospital, or in-hospital mortality < 48 h. Multiple imputations were used for missing values. Multivariable logistic regression analysis and Ridge penalization were performed to assess the association of predictors with nosocomial pneumonia and evaluate predictor stability. The predictive performance in addition to the existing prediction model was evaluated as well.

resultsThe study included 809 patients [median age 51 (IQR 32-68) years, 66.9% male, median ISS 10 (5-17), median GCS score 15 (14-15)]. Pneumonia incidence was 10.6% (n = 86). Age (OR 1.03 per year), ISS (OR 1.10 per point), GCS score (OR 0.91 per point), pulmonary contusion (OR 2.77), male sex (OR 1.36), hypertension (OR 1.86), diabetes (OR 1.20), number of rib fractures (OR 1.05 per fractured rib), and thoracic spine fracture (OR 1.51) were found to be predictors of nosocomial pneumonia. All variables showed added predictive value in addition to the existing model.

conclusionPatient history, injury severity, thoracic trauma, and traumatic brain injury are essential components of nosocomial pneumonia prediction and add to the predictive value of an existing model. Our results further build a basis for more accurate prediction. LEVEL OF EVIDENCE: Level III, prognostic/epidemiological.

Indexed as

Healthcare-Associated PneumoniaTrauma CentersAdultAgedCross InfectionFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsWounds and InjuriesAdded predictive valueLevel-1 traumaNosocomial pneumoniaPrediction modelPredictor finding

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.