Wilson, Jennie ORCID: https://orcid.org/0000-0002-4713-9662, Griffin, Hannah ORCID: https://orcid.org/0000-0001-6874-9825, Görzig, Anke ORCID: https://orcid.org/0000-0002-7623-0836, Prieto, J, Tingle, Alison and Loveday, Heather ORCID: https://orcid.org/0000-0003-2259-8149 (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.

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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 were captured from admission records. Multi-variate 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
Identifier:	10.1016/j.jhin.2023.09.020
Subjects:	Medicine and health > Health promotion and public health > Infection prevention Medicine and health > Clinical medicine > Clinical care
Depositing User:	Marc Forster
Date Deposited:	13 Sep 2024 08:49
Last Modified:	13 Sep 2024 09:00
URI:	https://repository.uwl.ac.uk/id/eprint/12434

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