Risk factors for hospital-acquired pneumonia among inpatients with mental disorders in a large mental health center within a tertiary general hospital

Am J Infect Control. 2023 Apr;51(4):446-453. doi: 10.1016/j.ajic.2022.06.014. Epub 2022 Jun 18.

Abstract

Background: Few researchers have investigated the incidence of and risk factors for hospital-acquired pneumonia (HAP) among inpatients with mental disorders in a general hospital.

Methods: This study included patients with mental disorders hospitalized in a large mental health center (situated in a general hospital) between January 1, 2017, and July 31, 2021 (excluding January 1, 2020- May 31, 2020). Risk factors for HAP were identified by logistic regression analysis after propensity score matching (PSM, 1:4) for gender, age, duration of observation, and hospital ward.

Results: The study included 16,864 patients. HAP incidence rate was 1.15% overall, 2.11% in closed wards, 0.75% in open wards, 4.45% in patients with organic mental disorders, 1.80% in patients with schizophrenia spectrum disorders, and 0.84% in patients with mood disorders. Risk factors for HAP after PSM were hypoproteinemia, chronic liver disease, use of clozapine, hospitalization during the previous 180 days, body mass index (BMI) ≤18.5 kg/m2, cholinesterase inhibitor use, and mood stabilizer use.

Conclusions: HAP was common among inpatients with mental disorders. Risk factors for HAP in patients with mental disorders include hypoproteinemia, chronic liver disease, hospitalization during the past 180 days, BMI ≤18.5 kg/m2, and use of clozapine, cholinesterase inhibitors, or mood stabilizers.

Keywords: General hospitals; Hospital-acquired pneumonia; Inpatients; Mental disorders; Risk factors.

MeSH terms

  • Clozapine*
  • Cross Infection* / complications
  • Cross Infection* / epidemiology
  • Healthcare-Associated Pneumonia*
  • Hospitals, General
  • Humans
  • Hypoproteinemia* / complications
  • Inpatients
  • Mental Disorders* / complications
  • Mental Disorders* / epidemiology
  • Mental Health
  • Pneumonia* / etiology
  • Risk Factors

Substances

  • Clozapine