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Temporal trends in postoperative and ventilator-associated pneumonia in the United States

Published online by Cambridge University Press:  03 November 2022

Mark L. Metersky Open the ORCID record for Mark L. Metersky [Opens in a new window] ,
Yun Wang ,
Michael Klompas ,
Sheila Eckenrode ,
Jasie Mathew Open the ORCID record for Jasie Mathew [Opens in a new window]  and
Harlan M. Krumholz Open the ORCID record for Harlan M. Krumholz [Opens in a new window]
Mark L. Metersky*
Affiliation:
Division of Pulmonary, Critical Care Medicine and Sleep Medicine, University of Connecticut School of Medicine, Farmington, Connecticut
Yun Wang
Affiliation:
Richard and Susan Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Beth Israel Deaconess Medical, Harvard Medical School, Boston, Massachusetts Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
Michael Klompas
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Sheila Eckenrode
Affiliation:
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
Jasie Mathew
Affiliation:
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
Harlan M. Krumholz
Affiliation:
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
*
Author for correspondence: Mark L. Metersky, E-mail: [email protected]
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Abstract

Objective:

To determine change in rates of postoperative pneumonia and ventilator-associated pneumonia among patients hospitalized in the United States during 2009–2019.

Design:

Retrospective cohort study.

Patients:

Patients hospitalized for major surgical procedures, acute myocardial infarction, heart failure, and pneumonia.

Methods:

We conducted a retrospective review of data from the Medicare Patient Safety Monitoring System, a chart-abstraction–derived database including 21 adverse-event measures among patients hospitalized in the United States. Changes in observed and risk-adjusted rates of postoperative pneumonia and ventilator-associated pneumonia were derived.

Results:

Among 58,618 patients undergoing major surgical procedures between 2009 and 2019, the observed rate of postoperative pneumonia from 2009–2011 was 1.9% and decreased to 1.3% during 2017–2019. The adjusted annual risk each year, compared to the prior year, was 0.94 (95% CI, 0.92–0.96). Among 4,007 patients hospitalized for any of these 4 conditions at risk for ventilator-associated pneumonia during 2009–2019, we did not detect a significant change in observed or adjusted rates. Observed rates clustered around 10%, and adjusted annual risk compared to the prior year was 0.99 (95% CI, 0.95–1.02).

Conclusions:

During 2009–2019, the rate of postoperative pneumonia decreased statistically and clinically significantly in among patients hospitalized for major surgical procedures in the United States, but rates of ventilator-associated pneumonia among patients hospitalized for major surgical procedures, acute myocardial infarction, heart failure, and pneumonia did not change.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 8 , August 2023 , pp. 1247 - 1254
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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