PREVALENCE AND DETERMINANT FACTORS OF HOSPITAL ACQUIRED PNEUMONIA IN POST OPERATIVE ADULT SURGICAL PATIENTS AT SPHMMC PREPARED

Abstract

Abstract BACKGROUND: Hospital acquired pneumonia is an inflammatory condition of the lung parenchyma that develops 48-72hours after hospital admission. Despite advances on surgical and anesthetic technique it persists as a frequent postoperative complication which is associated with significant morbidity and mortality. OBJECTIVE OF THE STUDY The aim of the research is to know prevalence and to identify modifiable and non modifiable risk factors of Hospital acquired pneumonia in post-operative adult surgical patients. METHODS: This was Hospital based Cross-sectional study for patients who were admitted and operated at SPHMMC. Secondary data were collected by reviewing patients’ medical records with the aid of pretested structured checklist. The collected data cleaned, edited, entered and analayzed with Statistical Product and Service Solutions SPSS Statistics v. 23. Statistical test chi square at 0.05 level of significance was used to assess the significance of association between variables. A Pvalue < 0.05 was considered statistically significant. To identify the prevalence and potential risk factors for HAP, we performed a multivariable Binary logistic regression analysis. RESULTS: 339 patients charts who fulfilled the inclusion criteria were revised .out of which 89(26.3%) developed hospital acquired pneumonia. Among patients who developed HAP; male to female ratio was 1:1.06 and 95.5% of patients were operated under general anesthesia. Being diabetic (AOR=11.23(1.61;78.22)),patients with repeated surgeries(AOR=20.59(1.17;361.60)), emergency surgeries(AOR=18.71(3.00;116.14)),patients above ASA class1(AOR=35.38(5.59;223.75)), age above 55yrs(AOR=36.28(6.60;199.32)),durations of surgeries above 2:30hrs(A0R=483.05(40.12;5814.77)) were independently associated with HAP. CONCLUSION: This study shown us the burden of postoperative HAP at SPHMMC was high. We retrospectively derived six determinant factors for developing post operative HAP. Detailed history, physical examination and investigation must be done preoperatively. Limiting duration of surgery particularly for emergency cases can decrease occurrence of HAP