BACKGROUND: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection among medical intensive care unit (ICU) patients and is associated with increased mortality and length of stay (LOS). Neurologic disease is a risk factor for VAP development, but the relationship between VAP and outcomes in patients admitted to the ICU for neurologic reasons remains largely unknown. METHODS: All mechanically ventilated patients over a 2-year period with neurovascular disease were included in a retrospective study. Data collected included patient demographics, dates of admission and discharge, LOS, and ventilator hours. Comparisons between neurologic patients who did and did not develop VAP were made using univariate and multivariate analysis. RESULTS: Of 585 intubated neurovascular patients, 24 (4.1%) developed VAP. Compared with those who did not develop VAP, those with VAP were younger (51.8 +/- 13.9 years vs. 58.8 +/- 15.9 years, P = 0.03), had increased LOS (32.6 +/- 29.2 days vs. 14.5 +/- 7.8 days, P < 0.001), and more ventilator hours (272 +/- 257 h vs. 85.9 +/- 140 h, P < 0.001). There was no difference in mortality between patients with and without VAP (25.0% vs. 28.3%, P = 0.72). VAP was not an independent predictor of mortality in a multivariate model (OR 1.11, 95% CI 0.37-3.30, P = 0.855). CONCLUSIONS: VAP in neurocritical care patients is associated with increased LOS and ventilator hours, but is not associated with increased mortality, contrary to prior studies in medical ICU patients.
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection among medical intensive care unit (ICU) patients and is associated with increased mortality and length of stay (LOS). Neurologic disease is a risk factor for VAP development, but the relationship between VAP and outcomes in patients admitted to the ICU for neurologic reasons remains largely unknown. METHODS: All mechanically ventilated patients over a 2-year period with neurovascular disease were included in a retrospective study. Data collected included patient demographics, dates of admission and discharge, LOS, and ventilator hours. Comparisons between neurologic patients who did and did not develop VAP were made using univariate and multivariate analysis. RESULTS: Of 585 intubated neurovascularpatients, 24 (4.1%) developed VAP. Compared with those who did not develop VAP, those with VAP were younger (51.8 +/- 13.9 years vs. 58.8 +/- 15.9 years, P = 0.03), had increased LOS (32.6 +/- 29.2 days vs. 14.5 +/- 7.8 days, P < 0.001), and more ventilator hours (272 +/- 257 h vs. 85.9 +/- 140 h, P < 0.001). There was no difference in mortality between patients with and without VAP (25.0% vs. 28.3%, P = 0.72). VAP was not an independent predictor of mortality in a multivariate model (OR 1.11, 95% CI 0.37-3.30, P = 0.855). CONCLUSIONS: VAP in neurocritical carepatients is associated with increased LOS and ventilator hours, but is not associated with increased mortality, contrary to prior studies in medical ICU patients.
Authors: Susan E Coffin; Michael Klompas; David Classen; Kathleen M Arias; Kelly Podgorny; Deverick J Anderson; Helen Burstin; David P Calfee; Erik R Dubberke; Victoria Fraser; Dale N Gerding; Frances A Griffin; Peter Gross; Keith S Kaye; Evelyn Lo; Jonas Marschall; Leonard A Mermel; Lindsay Nicolle; David A Pegues; Trish M Perl; Sanjay Saint; Cassandra D Salgado; Robert A Weinstein; Robert Wise; Deborah S Yokoe Journal: Infect Control Hosp Epidemiol Date: 2008-10 Impact factor: 3.254
Authors: Nicolas Bercault; Manuel Wolf; Isabelle Runge; Jean-Christian Fleury; Thierry Boulain Journal: Crit Care Med Date: 2005-11 Impact factor: 7.598