Impact of a hospital-acquired/ventilator-associated/healthcare-associated pneumonia practice guideline on outcomes in surgical trauma patients

The Journal of Trauma
Cathy L WorrallStuart M Leon

Abstract

Evidence-based guidelines for managing nosocomial pneumonia were published in 2005. Subsequently, our surgical critical care service developed and implemented an adaptation of this guideline for use in our surgical trauma intensive care unit (STICU). This study examined outcomes for two STICU cohorts treated for pneumonia before and after guideline implementation. A total of 130 charts were evaluated. The guideline cohort (GC) consisted of 65 patients with pneumonia managed by the surgical critical care service. These patients were prospectively identified for inclusion if they met specified clinical criteria for pneumonia diagnosis. The historical control cohort was identified retrospectively using ICD-9 coding. The primary outcome measure was ICU length of stay (LOS). Secondary outcome measures included overall LOS, mechanical ventilation days, mortality, and total cost of admission. The study was designed to have 80% power to detect a 1-day decrease in mean ICU LOS in a multivariable regression analysis. Descriptive differences were compared using two-sample t tests for continuous variables and chi for categorical variables. Baseline characteristics were not significantly different between cohorts. The multivariable regressi...Continue Reading

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Citations

Apr 6, 2013·Acta Anaesthesiologica Scandinavica·J D'HaeseJ Poelaert
Apr 16, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Tamar F BarlamKavita K Trivedi
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Feb 7, 2021·Journal of Global Antimicrobial Resistance·Tau Hong LeeJae-Hoon Song

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