Factors Affecting Poor Outcomes in Hospital-Acquired Pneumonia Patients Followed in the Intensive Care Unit: A Retrospective Cohort Study

Year 2025, Volume: 9 Issue: 3, 628 - 634, 30.09.2025

Tuba Tatlı Kış , Süleyman Yıldırım , Feride Tamay Tatlı , Muhammed Mehdi Ok , Can Biçmen , Cenk Kıraklı

https://doi.org/10.30621/jbachs.1753420

Abstract

Factors Affecting Poor Outcomes in Hospital-Acquired Pneumonia Patients Followed in the Intensive Care Unit: A Retrospective Cohort Study

Abstract

Purpose: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health problems worldwide. The aim of this study was to determine the etiological pathogens, susceptibility distribution, and parameters that may indicate poor prognosis in patients diagnosed with HAP/VAP and followed up in the intensive care unit (ICU).
Materyal-Metod: This study was designed as a retrospective cohort study. Demographic characteristics, causative microorganisms, susceptibility profiles of these pathogens, and 28-day mortality data (all-cause) of patients diagnosed with HAP and VAP who were hospitalized in the ICU were retrospectively reviewed from patient files. At the end of the 28-day period, patients were divided into survivor and non-survivor groups based on their survival status. Clinical parameters were compared between the two groups.
Results: This study included 142 patients diagnosed with HAP who were followed up at ICU. Of these, 102 (71.8%) patients were diagnosed with ventilator-associated pneumonia (VAP). The median age of the cohort was 72 years (IQR: 65–79), and 73.9% were male. The frequency of concomitant malignancy (43.0% vs 25.0%, p=0.029), WBC values at the onset of pneumonia [median 15.2 (IQR: 9.8–20.9) vs 11.9 (IQR: 8.6–14.4), p=0.010], procalcitonin levels [median 0.9 [(IQR: 0.3–5.3) vs 0.3 (IQR: 0.1–1.4) p=0.003], and the frequency of bacteremia secondary to pneumonia (39.5% vs 8.9% p<0.001) were found to be statistically significantly higher in the non-survivor group compared to the survivor group. The highest carbapenem resistance was detected in K. pneumonia (95.54%). The 28-day mortality rate was 60.6%. In multivariate analysis, concomitant bacteremia was independently associated with 28-day mortality (OR: 6.98, 95% CI: 2.37–20.54, p<0.001).
Conclusion: Mortality rates are high in HAP and VAP patients followed in the ICU. The development of bacteremia secondary to pneumonia is an independent risk factor for mortality.

Keywords

hospital-acquired pneumonia , ventilator-associated pneumonia , mortality

Ethical Statement

Ethical approval was obtained from the local ethics committee on 02/07/2025 with decision number 2025/55-39

Supporting Institution

None

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