The epidemiology of nonventilator hospital-acquired pneumonia in the United States

Am J Infect Control. 2018 Mar;46(3):322-327. doi: 10.1016/j.ajic.2017.09.005. Epub 2017 Oct 16.


Background: Nonventilator hospital-acquired pneumonia (NV-HAP) is among the most common hospital-acquired infections. The purpose of our study was to quantify the incidence and influence of NV-HAP in the United States using a national dataset.

Methods: The 2012 US National Inpatient Sample dataset was used to compare an NV-HAP group to 4 additional group cohorts: pneumonia on admission, general hospital admissions, matched on mortality and disease severity, and ventilator-associated pneumonia (VAP). The main outcome was NV-HAP incidence. The secondary outcome was to compare hospital length of stay, total hospital charges, and mortality between the NV-HAP group and the 4 additional group cohorts.

Results: The overall incidence of NV-HAP was 1.6%, which represents a rate of 3.63 per 1,000 patient-days. NV-HAP was associated with increased total hospital charges, a longer hospital length of stay, and greater likelihood of death in comparison to all groups except patients with VAP.

Conclusion: NV-HAP is an underappreciated and serious patient safety issue, resulting in significant increases in cost, length of stay, and mortality. Efforts toward prevention of NV-HAP should be raised to the same level of concern as VAP prevention.

Keywords: Hospital cost; Mortality; VAP.

MeSH terms

  • Health Care Costs
  • Healthcare-Associated Pneumonia / economics
  • Healthcare-Associated Pneumonia / epidemiology*
  • Healthcare-Associated Pneumonia / mortality
  • Humans
  • Incidence
  • Intensive Care Units
  • Pneumonia, Bacterial / epidemiology*
  • Pneumonia, Bacterial / etiology*
  • Risk Factors
  • United States