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. 2016 Jul;37(7):818-24.
doi: 10.1017/ice.2016.74. Epub 2016 Apr 13.

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

Isaac See  1 , Julia Chang  2 , Nicole Gualandi  1 , Genevieve L Buser  3 , Pamela Rohrbach  4 , Debra A Smeltz  4 , Mary Jo Bellush  5 , Susan E Coffin  6 , Jane M Gould  7 , Debra Hess  8 , Patricia Hennessey  7 , Sydney Hubbard  6 , Andrea Kiernan  7 , Judith O'Donnell  9 , David A Pegues  10 , Jeffrey R Miller  11 , Shelley S Magill  1
Affiliations

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

Isaac See et al. Infect Control Hosp Epidemiol. 2016 Jul.

Abstract

OBJECTIVE To determine the clinical diagnoses associated with the National Healthcare Safety Network (NHSN) pneumonia (PNEU) or lower respiratory infection (LRI) surveillance events DESIGN Retrospective chart review SETTING A convenience sample of 8 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 the NHSN to have PNEU or LRI, excluding adults with ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU and LRI events were recorded. RESULTS We reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to the NHSN; 29 reported events (12%) fulfilled neither PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassifications. Of 81 PNEU events in adults not on mechanical ventilation, 84% had clinician-diagnosed pneumonia; of these, 25% were attributed to aspiration. Of 43 adult LRI, 88% were in mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or noninfectious) 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 patients, 84% were mechanically ventilated and 21% had no corresponding clinical diagnosis documented. CONCLUSIONS In adults not on mechanical ventilation and in children, most NHSN-defined PNEU events corresponded with 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. Infect Control Hosp Epidemiol 2016;37:818-824.

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Conflict of interest statement

Conflict of interest. All authors report no conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
National Healthcare Safety Network surveillance flow diagram for Lower Respiratory Infections (LRI) in place during 2011–2012.
See this image and copyright information in PMC

Comment in

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