Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea

Tuberculosis and Respiratory Diseases

article

Ryoung-Eun Ko¹  Kyung Hoon Min²  Sang-Bum Hong³  Ae-Rin Baek⁴  Hyun-Kyung Lee⁵  Woo Hyun Cho⁶  Changhwan Kim⁷  Youjin Chang⁸  Sung-Soon Lee⁹  Jee Youn Oh²  Heung Bum Lee^1,10  Soohyun Bae^1,11  Jae Young Moon^1,12  Kwang Ha Yoo^1,13  Kyeongman Jeon¹ 

[1] Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine;Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital;Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine;Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchun hyang University Bucheon Hospital;Department of Internal Medicinn, Division of Pulmonology, Allergy and Critical Care Medicine, Busan Paik Hospital, Inje University College of Medicine;Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital;Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Sanggye Paik Hospital;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine;Department of Internal Medicine, Research Center for Pulmonary Disorders, Jeonbuk National University Medical School;Department of Internal Medicine, Ulsan University Hospital;Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital;Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine

关键词: Healthcare-Associated Pneumonia;    Ventilator-Associated Pneumonia;    Epidemiology;    Mortality;    Korea;   

DOI  :  10.4046/trd.2021.0018

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

BackgroundHospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. MethodsThis study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. ResultsUsing the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. ConclusionThis study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

【 授权许可】

CC BY-NC