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  • Author or Editor: Chun-Hao Wang x
  • Journal of Neurosurgery x
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Kuo-Wei Wang, Han-Jung Chen, Kang Lu, Po-Chou Liliang, Chun-Kai Huang, Pi-Lien Tang, Yu-Duan Tsai, Hao-Kuang Wang and Cheng-Loong Liang


The reported incidence of hospital-acquired bacterial pneumonia in critically ill trauma patients varies from as low as 4% to as high as 87%, with fatality rates varying from 6% to 59%. Clinical studies have identified the risk factors for pneumonia. The authors undertook this retrospective study to evaluate the incidence, risk factors, and outcomes of hospital-acquired bacterial pneumonia in a group of patients with severe head injuries.


This was a retrospective review of consecutive adult patients admitted to the neurosurgical ICU in the authors' hospital because of severe head injury (Glasgow Coma Scale scores ≤ 8) between January 2008 and December 2010.


During the study period, 290 patients were admitted to the neurosurgical ICU. Multivariate Cox regression analysis showed that age (HR 1.01, 95% CI 1.001–1.02), nasogastric tube insertion (HR 4.56, 95% CI 1.11–18.64), and hemiplegia or hemiparesis (HR 3.79, 95% CI 2.01–7.17) were significantly associated with the development of pneumonia.


The authors identified 3 risk factors (age, nasogastric tube insertion, and hemiplegia or hemiparesis) associated with the development of pneumonia in patients with severe head injury. This finding constituted the basis for developing a simple screening tool that can be used to assess the risk of occurrence of pneumonia in such patients.