Clinical Correlates of Surveillance Events Detected by National Healthcare Safety Network Pneumonia and Lower Respiratory Infection Definitions—Pennsylvania, 2011–2012

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  See, Isaac ; Chang, Julia ; Gualandi, Nicole ; Buser, Genevieve L. ; Rohrbach, Pamela ; Smeltz, Debra A. ; Bellush, Mary Jo ; Coffin, Susan E. ; Gould, Jane M. ; Hess, Debra ; Hennessey, Patricia ; Hubbard, Sydney ; Kiernan, Andrea ; O’Donnell, Judith ; Pegues, David A. ; Miller, Jeffrey R. ; Magill, Shelley S.
• Description:
  Objective
  
  To determine the clinical diagnoses associated with National Healthcare Safety Network (NHSN) pneumonia (PNEU) or lower respiratory infection (LRI) surveillance events.
  
  Design
  
  Retrospective chart review.
  
  Setting
  
  Eight acute care hospitals in Pennsylvania.
  
  Patients
  
  All patients hospitalized during 2011–2012.
  
  Methods
  
  Medical records were reviewed from a random sample of patients reported to NHSN to have PNEU or LRI, excluding adults with ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU/LRI events were recorded.
  
  Results
  
  We reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to NHSN; 29 (12%) of reported events fulfilled neither PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassification. Of 81 PNEU events in adults not on mechanical ventilation, 84% had clinician-diagnosed pneumonia, of which 25% were attributed to aspiration. Of 43 adult LRI, 88% were in mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or non-infectious) documented at the time of LRI. Of 36 pediatric PNEU events, 72% were ventilator-associated, and 70% corresponded to a clinical pneumonia diagnosis. Of 61 pediatric LRI, 84% were in mechanically-ventilated patients, and 21% had no corresponding clinical diagnosis documented.
  
  Conclusions
  
  In adults not on mechanical ventilation and in children, most NHSN-defined PNEU events corresponded to compatible clinical conditions documented in the medical record. In contrast, NHSN LRI events often did not. As a result, substantial modifications to the LRI definitions were implemented in 2015.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Child Child, Preschool Cross Infection Humans Infant Infant, Newborn Middle Aged Pennsylvania Pneumonia Pneumonia, Ventilator-Associated Population Surveillance Respiratory Tract Infections Retrospective Studies

  More +
• Source:
  Infect Control Hosp Epidemiol. 37(7):818-824
• Pubmed ID:
  27072043
• Pubmed Central ID:
  PMC5662932
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  37
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5902ff312468343a674a7202c18848e72ef7cd5ece17a80011df6a49bc7f3fd1
• Download URL:
  https://stacks.cdc.gov/view/cdc/49440/cdc_49440_DS1.pdf
• File Type:
  [PDF - 836.88 KB ]