Mohri et al evaluated patients for postoperative hospital-acquired pneumonia (HAP). The authors are from Mie University in Japan.
Criteria for postoperative hospital-acquired pneumonia:
(1) onset after surgery with no evidence prior to surgery
(2) one or both of the following:
(2a) clinical evidence on physical examination of the chest, with new onset of rales or dullness to percussion
(2b) radiographic evidence with new or progressive lung infiltrate, consolidation, cavitation or pleural effusion
(3) one or more laboratory features
Laboratory features:
(1) new onset of purulent sputum or change in sputum character
(2) isolation of a potential pathogen from blood culture
(3) isolation of potential pathogen from nonsputum respiratory specimen (biopsy, bronchial brushing, transtracheal aspirate)
(4) isolation of virus or detection of viral antigen from a respiratory specimen
(5) serologic evidence (IgM antibody or four-fold increase in IgG antibodies in paired serum samples)
(6) histopathologic evidence of pneumonia
where:
• The original table had laboratory features 1 to 3 for clinical evidence, but the other items would apply as well.
• There has to be a time limit for onset after surgery. After 3 weeks any association with surgery would seem tenuous.
