Wilson, Jennie, Griffin, Hannah, Görzig, Anke ORCID: https://orcid.org/0000-0002-7623-0836, Prieto, Jacqui, Seed, Kordo, Garvey, Mark I., Holden, Elisabeth, Tingle, Alison and Loveday, Heather (2023) Identifying patients at increased risk of non-ventilator associated pneumonia on admission to hospital: a pragmatic prognostic screening tool to trigger preventative action. Journal of Hospital Infection, 142. pp. 49-57. ISSN 0195-6701 (doi:10.1016/j.jhin.2023.09.020)

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Abstract

Background: Non-ventilator healthcare associated pneumonia (NV-HAP) is an important healthcare-associated infection. This study tested the feasibility of using routine admission data to identify those patients at high risk of NV-HAP who could benefit from targeted, preventive interventions.
Methods: Patients aged ≥64 years who developed NV-HAP five days or more after admission to elderly care wards, were identified by retrospective case note review together with matched controls. Data on potential predictors of NV-HAP was captured from admission records. Multivariate analysis was used to build a prognostic screening tool (PRHAPs); acceptability and feasibility of the tool was evaluated.
Results: A total of 382 cases/381 control patients were included in the analysis. Ten predictors were included in the final model; nine increased the risk of NV-HAP (OR between 1.68 and 2.42) and one (independent mobility) was protective (OR 0.48; 95% CI 0.30-0.75). The model correctly predicted 68% of the patients with and without NV-HAP; sensitivity 77%; specificity 61%. The PRHAPs tool risk score was 60% or more if two predictors were present and over 70% if three were present. An expert consensus group supported incorporating the PRHAPs tool into electronic logic systems as an efficient mechanism to identify patients at risk of NV-HAP and target preventative strategies.
Conclusions: This prognostic screening (PRHAPs) tool applied to data routinely collected when a patient is admitted to hospital, could enable staff to identify patients at greatest risk of NV-HAP, target scarce resources in implementing a prevention care bundle, and reduce the use of antimicrobial agents.

Item Type:	Article
Uncontrolled Keywords:	pneumonia; screening tool; prevention; risk
Subjects:	Q Science > QR Microbiology R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	21 Dec 2023 12:04
URI:	http://gala.gre.ac.uk/id/eprint/44463

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