Risk Factors and Outcomes of Lower Respiratory Infections in Patients with Traumatic Brain Injury

Alireza  Kashefizadeh; Aminollah  Vasigh; Seyed Hossein  Aghamiri

doi:10.18502/aacc.v11i3.18496

Alireza Kashefizadeh Department of Internal Medicine, School of Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Aminollah Vasigh Department of Anesthesiology, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
Seyed Hossein Aghamiri Department of Neurology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v11i3.18496

Keywords: Traumatic brain injury; Intensive care units; Hospital-acquired pneumoniae; Ventilator-associated tracheobronchitis; Ventilator-associated pneumoniae

Abstract

Background: Respiratory infections are a widespread and rapidly spreading disease that plays an important role in the mortality of children and adults. This study aimed to determine the prevalence, contributing factors, and outcomes of LRTI in patients with TBI.

Methods: In this study, 140 patients who were admitted to the ICU with a diagnosis of TBI were included in the study. Patients who had respiratory infections, including hospital-acquired pneumoniae (HAP), ventilator-associated tracheobronchitis (VAT), and ventilator-associated pneumoniae (VAP), were included in the group of patients with LRTI. The diagnosis of LRTI is based on laboratory indicators and the methodology of previous articles. The tool used in this study was a checklist including the data registry. This checklist was completed by the researchers and by visiting the department daily. In all stages of this study, the instructions issued by the Ethics Committee were followed. Also, data analysis was performed with the help of SPSS 18 software.

Results: In this study, out of 140 patients admitted to the ICU, 47 (33.6%) patients had LRTI and 93 (66.4%) patients had no symptoms of LRTI. The result showed that most patients were male (73.6%), had no history of pregnancy (99.3%), had no bedsores (81.4%), were admitted from the Emergency Department (52.9%), and had blunt trauma (79.3%). Also, the M(SD) age of the patients was 45.05 (11.1), the M(SD) length of hospital stay was 6.25 (1.8), and the mean (SD) consciousness score was 7.82 (2.22). Regarding the relationship between the status of the variables studied and the rate of LRTI, it was shown that there was a significant relationship between ICU LOS and age with LRTI status. So that the M(SD) of ICU LOS in patients with LRTI was 5.38 (2.21) and in patients without LRTI was 3.55 (1.45), (95% CI: 2.11 (1.98-2.23)). Also, the M(Sd) age of patients in the LRTI group was 46.76 (13.47), and in the No LRTI group was 44.19 (9.65) (95% CI: 1.87 (1.51-2.22)). Also, the mortality rate in patients with LRTI was 36.2%, which was higher than the mortality rate of non-LRTI patients with a mortality rate of 8.6%.

Conclusion: Given the high incidence of LRTI, preventive measures are recommended in this regard. Also, patient age and ICU LOS were identified as two important variables in the incidence of LRTI, which requires these patients to be prioritized for preventive care in order to reduce the incidence of LRTI.