We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Nosocomial Pneumonia and Mortality Among Patients in Intensive Care Units

Jean-Yves Fagon, MD; Jean Chastre, MD; Albert Vuagnat, MD; Jean-Louis Trouillet, MD; Ana Novara, MD; Claude Gibert, MD
JAMA. 1996;275(11):866-869. doi:10.1001/jama.1996.03530350048033.
Text Size: A A A
Published online


Objective.  —To evaluate the role that nosocomial pneumonia plays in the outcome of intensive care unit (ICU) patients.

Design.  —Cohort study.

Setting.  —Medical ICU, Hôpital Bichat, Paris, France, an academic tertiary care center.

Patients.  —A total of 1978 consecutive patients admitted to the ICU for at least 48 hours.

Main Outcome Measures.  —Various parameters known to be strongly associated with death of ICU patients were recorded: age, location before admission to the ICU, diagnostic categories, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiologic Score, McCabe score, number and type of dysfunctional organs, and the development of nosocomial bacteremia and nosocomial urinary tract infection. These variables and the presence or absence of nosocomial pneumonia were compared between survivors and nonsurvivors and entered into a stepwise logistic regression model to evaluate their independent prognostic roles.

Results.  —Nosocomial pneumonia developed in 328 patients (16.6%) whose mortality rate was 52.4% compared with 22.4% for patients without ICU-acquired pneumonia (P<.001). APACHE II score (odds ratio [OR]=1.08; 95% confidence interval [CI], 1.06 to 1.10; P<.001), number of dysfunctional organs (OR=1.54; 95% CI, 1.36 to 1.74; P<.001), nosocomial pneumonia (OR=2.08; 95% CI, 1.55 to 2.80; P<.001), nosocomial bacteremia (OR=2.51; 95% CI, 1.78 to 3.55; P<.001), ultimately or rapidly fatal underlying disease (OR=1.76; 95% CI, 1.38 to 2.25; P<.001), and admission from another ICU (OR=1.30; 95% CI, 1.01 to 1.68; P=.04) were significantly associated with mortality.

Conclusion.  —These data suggest that, in addition to the severity of underlying medical conditions and nosocomial bacteremia, nosocomial pneumonia independently contributes to ICU patient mortality.(JAMA. 1996;275:866-869)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.