Identification of Early Predictors for Post-Traumatic Pneumonia

Croce, Martin A.; Fabian, Timothy C.; Waddle-Smith, Linda; Maxwell, Robert A.
February 2001
American Surgeon;Feb2001, Vol. 67 Issue 2, p105
Academic Journal
We demonstrated that the standard clinical criteria of fever, leukocytosis, purulent sputum, and infiltrate on chest radiograph are nonspecific for the diagnosis of post-traumatic pneumonia, and only is similar to 50 per cent of patients with these conditions have pneumonia. Quantitative cultures of bronchoalveolar lavage effluent will differentiate pneumonia (requiring antibiotic therapy) from systemic inflammatory response syndrome (not requiring antibiotics). Early identification of patients at risk for pneumonia can target populations for clinical research. Because risk factors for pneumonia when diagnosed by quantitative cultures have not been defined we reviewed our recent experience to identify variables predictive of pneumonia. Patients over a 22-month period who survived >48 hours were identified from the trauma registry. Pneumonia was defined as growth of is greater than or equal to 10[sup 5] organisms per milliliter in the bronchoalveolar lavage effluent. Risk factors evaluated included injury severity and severity of shock. There were 7503 patients (75% with blunt and 25% with penetrating injuries). The incidence of pneumonia was 6 per cent (7% of patients with blunt and 2% of patients with penetrating injuries). Logistic regression analysis identified age; Glasgow Coma Scale score; Injury Severity Score; transfusion requirements during resuscitation; spinal cord injury; chest injury severity; and emergent femur fixation, craniotomy, and laparotomy as being independent predictors of pneumonia. We conclude that multiple risk factors, which are all able to be determined early after injury, are predictive of post-traumatic pneumonia. Prompt identification of this high-risk group of patients allows prognostic considerations relative to patient management schemes and targets populations for prophylactic measures or immunomodulation.


Related Articles

  • Options in Community-Acquired Pneumonia. Kirchner, Jeffrey T. // American Family Physician;2/1/2000, Vol. 61 Issue 3, p794 

    Discusses research on community-acquired pneumonia. Reference to a study by S. Moola, et al., from the October 1999 issue of the `Chest'; Difficulty of distinguishing bacterial pneumonia in community-acquired pneumonia; Diagnosis of pneumonia in patients; Treatment of pneumonia by grepafloxacin...

  • SARS fears spreading. Aldred, Carolyn // Business Insurance;4/14/2003, Vol. 37 Issue 15, p1 

    This article focuses on the spread of severe acute respiratory syndrome (SARS). The pneumonia-type virus broke out in China and Hong Kong and there were 2,781 total cases and 111 deaths, according to the World Health Organization, which has issued travel advisories for the affected areas....

  • C pneumoniae infections require early diagnosis.  // Brown University Long-Term Care Quality Advisor;08/11/97, Vol. 9 Issue 15, p3 

    States that an important cause of respiratory disease outbreaks in nursing homes is chlamydia pneumoniae. What these outbreaks could result in; Information on a case study carried out; What the results from the study indicated.

  • Prevalence of human metapneumovirus in hospitalized children with respiratory tract infections in Tianjin, China. Xiao-yan Li; Jin-ying Chen; Mei Kong; Xu Su; Yan-ping Yi; Ming Zou; Hua Zhang // Archives of Virology;Nov2009, Vol. 154 Issue 11, p1831 

    Human metapneumovirus (hMPV) has recently been recognized as an important respiratory pathogen, especially in children. At present, our understanding of the characteristics of hMPV from China is very limited. Nasopharyngeal aspirates were taken from 310 hospitalized pediatric patients. Twenty...

  • Can community health workers and caretakers recognise pneumonia in children? Experiences from western Uganda. Källander, Karin; Tomson, Göran; Nsabagasani, Xavier; Sabiiti, Jesca Nsungwa; Pariyo, George; Peterson, Stefan // Transactions of the Royal Society of Tropical Medicine & Hygiene;Oct2006, Vol. 100 Issue 10, p956 

    Summary: Acute respiratory infections (ARI) are leading killers of children. Case management using community health workers (CHW) has halved ARI mortality in children in Asia. WHO/UNICEF recommend integrating pneumonia into Home Management of Malaria strategies. However, in sub-Saharan Africa,...

  • A pneumonia that does not improve. Naviglio, Samuele; Chinello, Matteo; Ventura, Alessandro // Archives of Disease in Childhood -- Education & Practice Edition;Feb2015, Vol. 100 Issue 1, p18 

    A quiz concerning pneumonia in a 2-year-old child is presented.

  • Respiratory diseases in children and outdoor air pollution in São Paulo, Brazil: a time series analysis. Gouveia, Nelson; Fletcher, Tony; Gouveia, N; Fletcher, T // Occupational & Environmental Medicine;Jul2000, Vol. 57 Issue 7, p477 

    Objectives: To investigate the short term effects of air pollution on the respiratory morbidity of children living in São Paulo, Brazil, one of the largest cities in the developing world.Methods: Daily counts of hospital admissions due to respiratory diseases along...

  • Respiratory virus surveillance in hospitalised pneumonia patients on the Thailand-Myanmar border. Turner, Paul; Turner, Claudia; Watthanaworawit, Wanitda; Carrara, Verena; Cicelia, Naw; Deglise, Carole; Phares, Christina; Ortega, Luis; Nosten, Francois // BMC Infectious Diseases;2013, Vol. 13 Issue 1, p1 

    Background: Pneumonia is a significant cause of morbidity and mortality in the developing world. Viruses contribute significantly to pneumonia burden, although data for low-income and tropical countries are scarce. The aim of this laboratory-enhanced, hospital-based surveillance was to...

  • SECTION 4: RESPIRATORY DISEASES. Silverstein, Alvin; Silverstein, Virginia; Silverstein, Robert // Respiratory System (9780805028317);1994, p62 

    This article discusses respiratory diseases. Cold viruses attack the mucous membrane lining the nose and throat. Influenza can be caught by breathing tiny virus-carrying droplets of moisture that people have coughed or sneezed into the air. In pneumonia the inflammation and fluid fill the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics