The association between non-ventilator associated hospital acquired pneumonia and patient outcomes among U.S. Veterans

The association between accessing dental services and nonventilator hospital-acquired pneumonia among 2019 Medicaid beneficiaries

“…For veterans (2015-2020), the NVHAP rate was 1.26 cases per 1,000 hospitalized days. 10 The VA study authors compelled hospitals to implement universal prevention for NVHAP. 10 To the best of our knowledge, this is the first study to demonstrate a relationship between outpatient preventive dental and periodontal treatment decreased NVHAP during inpatient hospitalization.…”

“…10 The VA study authors compelled hospitals to implement universal prevention for NVHAP. 10 To the best of our knowledge, this is the first study to demonstrate a relationship between outpatient preventive dental and periodontal treatment decreased NVHAP during inpatient hospitalization. This finding is consistent with prior research focused on inpatient oral healthcare during acute-care hospitalizations and NVHAP prevention.…”

Non-ventilator associated hospital acquired pneumonia (NV-HAP) risk among hospitalized veterans before and during the COVID-19 pandemic

“…We identified a cohort of 1,567,275 U.S. Veterans admitted to 135 VA facilities in acute care settings between 10/1/2015 and 3/31/2021with a minimum 48-hour length of stay. Consistent with prior work, 2 transfer admissions were excluded as well as admissions with index diagnoses of acute respiratory distress, respiratory failure, respiratory arrest, asphyxia, or pneumonia indicated as present on admission (POA). The primary exposure was a positive SARS-CoV-2 test within the 28 days prior to admission date, referred to as COVID-19.…”

“…The outcome of NV-HAP was identified based on International Classification of Diseases (ICD-10) codes for bacterial pneumonia indicated as not POA. 2 Patient demographics, comorbidities, exposure, and outcomes were identified using the VHA Corporate Data Warehouse (CDW). 3…”

“… 4 The following covariates were included a-priori for risk adjustment based on prior work: age, gender, recent diagnoses of peripheral vascular disease, chronic pulmonary disease, and cancer. 2 A cyclic cubic regression spline for admission month was included to adjust for seasonality. The trend in NV-HAP IR was estimated by a thin plate regression spline fit 5 separately for pre-COVID-19 era admissions (prior to 2/1/2020) and COVID-19 era admissions, with posterior simulations from model parameters used to identify era specific IR and the number of cases associated with that change in risk.…”