Yao et al reported risk factors for a nosocomial pneumonia occurring in a patient with a hip fracture. These can help to identify a patient who may benefit from more aggressive management. The authors are from China Medical University in Dandong, China.
Patient selection: hospitalized patient with hip fracture
Key risk factors for hospital-acquired pneumonia:
(1) older age (> 70 years OR 2.3; > 80 OR 3.0)
(2) COPD (OR 3.4)
(3) time from injury to operation (OR 1.09 per hour; >= 48 hours OR 3.6)
(4) hypoalbuminemia (< 3.0 g/dL OR 3.0; < 3.5 g/dL OR 2.7)
Additional risk factors:
(1) male gender
(2) dependent functional status
(3) history of smoking
(4) history of stroke or CVA
(5) history of cancer
(6) impaired cognitive function
(7) presence of comorbidities (partially overlaps with ASA)
(8) ASA >= 3
(9) duration of surgery >= 2 hours
(10) admission to ICU
(11) extramedullary operation
(12) anemia
(13) high RDW
(14) high serum creatinine
(15) mechanical ventilation
