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  • Title: [Risk factors associated with the presence of pneumonia in patients with brain injury].
    Author: Yepes D, Molina F, Ortiz G, Aguirre R.
    Journal: Biomedica; 2009 Jun; 29(2):253-9. PubMed ID: 20128350.
    Abstract:
    INTRODUCTION: Pneumonia in patients with head trauma occurs commonly; however, few data are available to evaluate the effects of the infection on the prognosis. OBJECTIVE: The incidence and microbiological findings were described, and the associated risk factors were established with the appearance of pneumonia in patients with severe brain trauma. MATERIALS AND METHODS: A prospective cohort study was conducted that included 39 patients with severe brain trauma and who required mechanical ventilation; initially, none had pneumonia. These patients were observed during a 24-month period in an attempt to discern the principal risk factors associated with the onset of pneumonia. RESULTS: Pneumonia occurred in 31 (80%) of the 39 patients, and 28 of these presented early pneumonia. The most frequent germ in patients with pneumonia was Staphylococcus aureus with a percentage of the 42.4%. In the multivariate analysis, the single statistically significant risk factor was the presence of hypotension and vasopressor support with a RR = 27.9 (95% CI = 1.0-749.9, p < 0.05). No significant differences in the days of mechanical ventilation or mortality in both groups. The major mortality-associated risk factor in patients with pneumonia was a low Glasgow score at admittance with an OR = 2.19 (95% CI 1.03 - 4.65), p < 0.05. CONCLUSIONS: The incidence of pneumonia in patients with severe brain trauma is high; however, its appearance does not affect the prognosis. The single significant risk factor was the presence of hypotension and vasopressor support.
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