非呼吸机医院获得性肺炎 (NV-HAP) 患者的粗死亡率和调整死亡率是所有医疗保健相关感染中最高的，因此人们呼吁加强预防。然而，易患 NV-HAP 的患者在基线时往往病情严重，因此不清楚他们的高死亡率是由 NV-HAP、基础疾病还是两者兼而有之。 两位传染病医生对 150 名随机选择的患者进行了详细的病历审查2016 年 4 月至 2021 年 5 月期间，来自 4 家医院的 NV-HAP 事件后在院内死亡的成人。评审人员提取了风险因素，估计了 NV-HAP 的可预防性，确定了死亡原因，并判定了死亡的可预防性。患者中位数年龄为 69.3 岁（IQR 60.7-77.4），43.3% 为女性。合并症很常见：57% 患有癌症，30% 患有慢性肾病，29% 患有慢性肺病，27% 患有心力衰竭。 54% 的人在接受 NV-HAP 之前至少存在一种符合临终关怀资格的病症，24% 的人在接受“不要复苏”命令之前存在至少一种符合临终关怀资格的病症。大多数 (99%) 具有难以改变的 NV-HAP 危险因素：76% 的精神状态改变、35% 的吞咽困难和 27% 的鼻胃管/口胃管。 21% 的人认为 NV-HAP 是可以或可能预防的，8.6% 的人认为医院死亡可能或非常有可能是可以预防的。大多数 NV-HAP 后死亡的患者都有多种严重的潜在合并症和难以改变的 NV-HAP 危险因素。只有五分之一最终导致死亡的 NV-HAP 和 NV-HAP 后死亡的十二分之一被认为是可以预防的。这并没有削弱 NV-HAP 预防计划的重要性，而是告知人们对其对医院死亡影响的潜在程度的预期。© 作者 2024。由牛津大学出版社代表美国传染病学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限均可通过我们网站文章页面上的“权限”链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

Crude and adjusted mortality rates for patients with non-ventilator hospital-acquired pneumonia (NV-HAP) are amongst the highest of all healthcare-associated infections, leading to calls for greater prevention. Patients prone to NV-HAP, however, tend to be severely ill at baseline making it unclear whether their high mortality rates are due to NV-HAP, underlying conditions, or both.Two infectious disease physicians conducted detailed medical record reviews on 150 randomly selected adults from 4 hospitals who died in-hospital following an NV-HAP event between April 2016 and May 2021. Reviewers abstracted risk factors, estimated the preventability of NV-HAP, identified causes of death, and adjudicated the preventability of death.Patients' median age was 69.3 (IQR 60.7-77.4) and 43.3% were female. Comorbidities were common: 57% had cancer, 30% chronic kidney disease, 29% chronic lung disease, and 27% heart failure. At least one hospice-eligible condition was present before NV-HAP in 54% and "Do Not Resuscitate" orders in 24%. Most (99%) had difficult-to-modify NV-HAP risk factors: 76% altered mental status, 35% dysphagia, and 27% nasogastric/orogastric tubes. NV-HAP was deemed possibly or probably preventable in 21% and hospital death likely or very likely preventable in 8.6%.Most patients who die following NV-HAP have multiple, severe underlying comorbidities and difficult-to-modify risk factors for NV-HAP. Only 1 in 5 NV-HAPs that culminated in death and 1 in 12 deaths following NV-HAP were judged potentially preventable. This does not diminish the importance of NV-HAP prevention programs but informs expectations about the potential magnitude of their impact on hospital deaths.© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.