Factors Related to the Risk for Hospital-Acquired Pneumonia

Hospital patient ventilator
Hospital patient on ventilator
Researchers in South Korea found poverty and pre-existing respiratory conditions were among the diverse risk factors for hospital-acquired pneumonia.

Hospital-acquired pneumonia (HAP) is associated with a range of sociodemographic, clinical, and hospital-environmental factors. As a result, a comprehensive approach to prevention is needed. These were among the findings of a recent population-based retrospective cohort study published in BMC Pulmonary Medicine

While HAP is an exogenous infection with nosocomial pathogens acquired from the hospital environment, little data are available on the hospital environment-associated risk factors for HAP. Data are also limited on the social factors that may be associated with HAP.

In the current study, researchers in South Korea conducted a comprehensive risk assessment using national health insurance claims data to determine the sociodemographic, clinical, and hospital environmental factors associated with the incidence of HAP. They conducted multivariable logistic regression analyses on 512,278 adult patients who were hospitalized for more than 3 days between January 1, 2016 through December 31, 2018 and identified 25,369 (5.0%) HAP cases.

The investigators found that the incidence of HAP was associated with well-known risk factors for HAP —  such as older age (over 70 years vs 20 to 29 years), male sex, pre-existing lung diseases, asthma, chronic obstructive pulmonary disease, chronic lower airway disease, tube feeding, suctioning, positioning, use of mechanical ventilation, and intensive care unit admission. Researchers also found that a number of sociodemographic and environmental factors were associated with the incidence of HAP, poverty, general hospitals, higher bed-to-nurse ratio (Grade ≥5), higher number of beds per hospital room (6 beds), and ward with caregiver.

Researchers concluded that the incidence of HAP was associated with various sociodemographic, clinical, and hospital environmental factors. ”Thus, health professionals should work with various stakeholders, such as hospital management personnel and policymakers, to develop strategies to reduce HAP,” noted the researchers.


Kim B-G, Kang M, Lim J, et al.  Comprehensive risk assessment for hospital-acquired pneumonia: sociodemographic, clinical, and hospital environmental factors associated with the incidence of hospital-acquired pneumonia. BMC Pulm Med. 2022;22(1):21. doi: 10.1186/s12890-021-01816-9