Development and Assessment of Objective Surveillance Definitions for Nonventilator Hospital-Acquired Pneumonia

Key Points Question Is it possible to conduct operational surveillance using the clinical data routinely recorded in electronic health records to identify nonventilated adults with hospital-acquired pneumonia? Findings In this cohort study of 310 651 patients with 489 519 admissions, an electronic surveillance definition based on worsening oxygenation, at least 3 days of new antibiotics, fever or abnormal white blood cell count, and performance of chest imaging was successfully applied to all patients. This definition identified 0.6 event per 100 admissions and was associated with up to a 6-fold higher risk of hospital death compared with matched control patients. Meaning This study suggests that electronic surveillance for nonventilator hospital-acquired pneumonia is feasible; this approach could inform the development and evaluation of pneumonia prevention programs in hospitals.