Risk factors for lower respiratory tract infections in a psychiatric hospital: a retrospective study

Abstract

Introduction: Locked pediatric inpatient psychiatric units are vulnerable to the emergence and spread of infections, and nosocomial infection, especially respiratory tract infection is potentially a major problem. This study aimed to explore the risk factors for lower respiratory tract infection (LRI), in particular, pneumonia.

Methodology: We conducted a retrospective study comprising 4643 patients with schizophrenia (SZ) and 1826 patients with major depressive disorder (MDD), and the chi-square test was performed to analyze the categorical variables.

Results: The risk ratio for LRI, including pneumonia, in intensive care unit (ICU) was higher than in the general ward, and electroconvulsive therapy (ECT) increased the patients' susceptibility to LRI and pneumonia. Our data have revealed that patients treated with restraint or clozapine showed a higher prevalence of LRI and pneumonia, and the results indicated that the increased risk of LRI, not pneumonia, was dose-dependently observed in patients with clozapine treatment.

Conclusions: Our study shows that ICU and ECT treatment were risk factors for LRI and pneumonia in patients with SZ or MDD, and patients with SZ has a prevalence of hospital-acquired infection because of restraint and clozapine treatments.

Keywords: Nosocomial infection; low respiratory tract infection; major depressive disorder; pneumonia; risk factors; schizophrenia.