DRG Category: 177

Mean LOS: 8.9 days

Description MEDICAL: Respiratory Infections and Inflammations with Major CC

DRG Category: 193

Mean LOS: 6.6 days

Description MEDICAL: Simple Pneumonia and Pleurisy with Major CC

DRG Category: 207

Mean LOS: 15.1 days

Description MEDICAL: Respiratory System Diagnosis with Ventilator Support 96+ Hours

DRG Category: 208

Mean LOS: 7.2 days

Description MEDICAL: Respiratory System Diagnosis with Ventilator Support < 96 Hours

DRG Category: 3

Mean LOS: 38.5 days

Description SURGICAL: Tracheostomy with MV 96+ Hours or Primary Diagnosis Except for Face, Mouth, and Neck with Major Operating Room

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An increasing global awareness now exists because of the threat of epidemics of pneumonia, the severity of which can range from a mild illness to a life-threatening condition. Diseases such as severe acute respiratory syndrome (SARS), avian influenza (A/H5N1), and H1N1 (swine flu) are examples of viral pneumonias associated with high mortality and morbidity. Bacterial pneumonia can occur in several settings: community acquired pneumonia (CAP), nursing home acquired pneumonia (NHAP), healthcare associated pneumonia (HCAP), hospital acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP). Nosocomial pneumonia is an older term that incorporates HAP and VAP.

Pneumonia is an inflammatory condition of the interstitial lung tissue in which fluid and blood cells escape into the alveoli. More than 3 million people in the United States are diagnosed each year with pneumonia. The disease process begins with an infection in the alveolar spaces. As the organism multiplies, the alveolar spaces fill with fluid, white blood cells, and cellular debris from phagocytosis of the infectious agent. The infection spreads from the alveolus and can involve the distal airways (bronchopneumonia), part of a lobe (lobular pneumonia), or an entire lung (lobar pneumonia).

The inflammatory process causes the lung tissue to stiffen, resulting in a decrease in lung compliance and an increase in the work of breathing. The fluid-filled alveoli cause a physiological shunt, and venous blood passes unventilated portions of lung tissue and returns to the left atrium unoxygenated. As the arterial oxygen tension falls, the patient begins to exhibit the signs and symptoms of hypoxemia. In addition to hypoxemia, pneumonia can lead to respiratory failure and septic shock. Infection may spread via the bloodstream and cause endocarditis, pericarditis, meningitis, or bacteremia.