Table 2.

Prevalence and Effect of Potential Factors for ND Pneumonia, Among Adults Hospitalized for >2 Days Between 2015 and 2017

Characteristic	Prevalence No. (%)	Crude		Adjusteda
		HR (95% CI)	P Value	HR (95% CI)	P Value
Female	49,500 (56)	0.64 (0.50–0.82)	.0003	0.77 (0.59–1.00)	.05
Age, y
18–39	28,007 (32)	Ref	…	Ref	…
40–49	11,018 (12)	2.41 (1.43–4.08)	.001	2.26 (1.28–3.98)	.005
50–59	15,631 (18)	3.24 (2.05–5.12)	<.0001	2.58 (1.53–4.36)	.004
60–69	16,400 (19)	3.92 (2.52–6.12)	<.0001	2.98 (1.78–4.97)	<.0001
≥70	17,431 (20)	3.75 (2.39–5.88)	<.0001	2.59 (1.50–4.49)	.0007
Chronic pulmonary disease
Chronic bronchitis/emphysema	3,077 (4)	2.98 (2.14–4.17)	<.0001	2.07 (1.40–3.06)	.0003
Asthma	8,572 (10)	0.95 (0.63–1.42)	.79	1.17 (0.75–1.81)	.49
Bronchiectasis	1,121 (1)	0.33 (0.08–1.31)	.11	0.54 (0.14–2.18)	.39
Other/unspecified COPD	6,923 (8)	1.14 (0.78–1.67)	.49	0.85 (0.56–1.31)	.47
Other comorbidities
Prior MI	5,434 (6)	1.34 (0.90–1.99)	.15	0.91 (0.58–1.42)	.67
Heart failure	12,538 (14)	1.71 (1.32–2.21)	<.0001	1.48 (1.07–2.05)	.02
Cerebrovascular disease	1,923 (2)	1.29 (0.66–2.51)	.55	0.89 (0.41–1.93)	.77
Dementia	2,376 (3)	0.47 (0.21–1.06)	.07	0.41 (0.18–0.95)	.04
Rheumatoid arthritis	1,708 (2)	0.68 (0.26–1.80)	.44	0.52 (0.19–1.38)	.19
Peptic ulcer disease	441 (1)	1.21 (0.38–3.82)	.75	0.92 (0.28–3.03)	.92
Diabetes	20,821 (23)	1.06 (0.82–1.37)	.65	0.83 (0.61–1.13)	.23
Liver disease	3,320 (4)	1.96 (1.32–2.89)	.0008	1.48 (0.95–2.32)	.09
Renal disease	13,120 (15)	1.26 (0.96–1.65)	.09	0.94 (0.69–1.28)	.68
Paralysis	1,915 (2)	2.12 (1.39–3.24)	.0005	1.72 (1.09–2.73)	.02
Immunosuppression	36,199 (41)	1.55 (1.22–1.96)	.0007	1.54 (1.18–2.00)	.001
Body mass index
Under/normal weight	24,535 (33)	Ref	…	Ref	…
Overweight	21,129 (29)	0.83 (0.62–1.09)	.18	1.33 (0.98–1.82)	.07
Obese	27,677 (38)	0.63 (0.48–0.84)	.002	0.80 (0.57–1.14)	.21
Trauma admission	9,683 (11)	1.02 (0.75–1.39)	.91	1.00 (0.70–1.43)	.99
Intensive care unit stayb	15,767 (20)	1.98 (1.53–2.55)	<.0001	1.49 (1.06–2.09)	.02
MEWS
0–1	18,917 (27)	Ref	…	Ref	…
2	27,062 (39)	0.95 (0.69–1.32)	.77	1.07 (0.77–1.49)	.70
3	12,380 (18)	0.94 (0.65–1.37)	.74	0.95 (0.65–1.40)	.80
≥4	11,367 (16)	1.14 (0.82–1.60)	.44	1.07 (0.76–1.52)	.69
Morse fall risk score
0	4,626 (6)	Ref	…	Ref	…
1–24	19,862 (25)	0.91 (0.37–2.24)	.84	0.79 (0.32–1.92)	.60
25–45	33,833 (42)	1.87 (0.83–4.24)	.13	1.03 (0.44–2.38)	.95
>45	21,595 (27)	2.93 (1.30–6.63)	.01	1.58 (0.68–3.70)	.29
Inpatient medicationsb
Anesthesia, local	23,820 (27)	1.06 (0.84–1.34)	.63	0.92 (0.69–1.22)	.54
Anesthesia, general	5,454 (6)	1.57 (1.21–2.05)	.0008	1.12 (0.68–1.83)	.66
Antibiotics	51,841 (59)	1.45 (1.06–1.97)	.02	1.12 (0.74–1.70)	.59
Antipsychotics	22,960 (26)	0.87 (0.69–1.10)	.25	1.03 (0.80–1.33)	.84
Benzodiazepines	28,293 (32)	0.94 (0.73–1.21)	.64	0.79 (0.58–1.07)	.12
H2 blockers	15,833 (18)	1.29 (1.02–1.65)	.04	0.97 (0.71–1.31)	.81
Proton-pump inhibitors	27,510 (31)	1.48 (1.18–1.87)	.0009	1.16 (0.90–1.50)	.25
Opioids	59,813 (68)	1.69 (1.17–2.45)	.005	1.27 (0.78–2.07)	.33
Total parenteral nutritionb	1,544 (2)	1.56 (1.09–2.24)	.02	1.37 (0.91–2.08)	.14
Prior ventilationb
Endotracheal	13,939 (16)	1.42 (1.11–1.82)	.005	1.10 (0.78–1.55)	.59
Tracheostomy	4,348 (5)	1.05 (0.75–1.47)	.76	0.89 (0.61–1.30)	.54
Chlorhexidine mouthwashb	6,362 (7)	1.53 (1.18–1.98)	.001	0.90 (0.54–1.52)	.69

Note. HR, hazard ratio; CI, confidence interval; Ref, reference; MI, myocardial infarction; MEWS, modified early warning system; H2 blockers, histamine-type 2 receptor blockers.

^aAdjusted for all risk factors in the table above; correlation between repeat hospitalizations of the same patients were taken into account using a robust sandwich covariance matrix and inpatient mortality was treated as a competing risk using the Fine and Gray model. Inverse probability of missingness weights were used to account for missing data.

^bTreated as a time-varying exposure; patients were considered exposed for the remainder of the hospitalization.