Clinical characteristics and factors associated with diagnoses of ventilator and non-ventilator associated pneumonia in Intensive care unit

Abstract

Introduction: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality in ventilated patients in intensive care units (ICUs) worldwide. This study was conducted to identify the proportion, associated factors and outcomes of patients who developed VAP.

Materials and methods: This was a retrospective, crosssectional study involving 111 ventilated patients admitted to the ICU at Hospital Universiti Sains Malaysia (HUSM) from 1 April 2018 to 30 June 2019. The patients were categorised into VAP and non-VAP groups using the clinical scoring for VAP at the end of the stay in ICU. Logistic regression analysis was performed to determine the factors independently associated with VAP and its outcomes.

Results: Thirty-three patients were categorised into the VAP group and the remaining 77 patients were categorised into the non-VAP group. The proportion of patients who developed VAP was 30.0%. The VAP rate per 1000 people according to the Johansen, Clinical Pulmonary Infection Score (CPIS), and Center for Disease Control and Prevention (CDC) criteria were 6.9, 6.1 and 0.4, respectively. There was an association between duration of mechanical ventilation (MV; odds ratio [OR] = 1.22; 95% confidence interval [CI] 1.12, 1.34; p < 0.01) and length of ICU stay (OR = 1.213; 95% CI 1.107, 1.32; p < 0.01) and VAP. However, there was no difference in the patients between VAP and non-VAP groups in terms of mortality.

Conclusion: The VAP rate differs according to the diagnostic criteria. The factors associated with VAP in our centre were increased duration of MV and increased length of ICU stay. There was no difference in the mortality rate between the VAP and non-VAP groups.