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Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece.
Respir Care. 2003 Jul; 48(7):681-8.RC

Abstract

INTRODUCTION

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection among intensive care unit (ICU) patients.

OBJECTIVE

Prospectively identify the factors associated with development of VAP and examine the incidence of VAP.

SUBJECTS

Over a 6-month period we had 175 patients who required mechanical ventilation for longer than 24 hours.

RESULTS

VAP occurred in 56 patients (32%). Stepwise logistic regression analysis identified 5 factors independently associated with VAP (p < 0.05): bronchoscopy (adjusted odds ratio [AOR] = 2.95; 95% confidence interval [CI], 1.1-8.3; p = 0.036); tube thoracostomy (AOR = 2.78; 95% CI, 1.1-6.6; p = 0.023); tracheostomy (AOR = 3.56; 95% CI, 1.7-8.4; p = 0.002); Acute Physiology and Chronic Health Evaluation (APACHE II) score >/= 18 (AOR = 2.33; 95% CI, 1.1-5.1; p = 0.033); and enteral feeding (AOR = 2.89; 95% CI, 1.3-7.7; p = 0.026). The duration of mechanical ventilation was longer among patients who developed VAP (p < 0.001). VAP was not associated with the cause of ICU admission.

CONCLUSIONS

VAP is a common infection and certain interventions might affect the incidence of VAP. ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP and modifying patient care to minimize the risk of VAP, such as avoiding unnecessary bronchoscopy or modulating enteral feeding.

Authors+Show Affiliations

Apostolopoulou E
Nursing Department, Athens University, 36 Figalias Street, 145 64, Athens, Greece. ektelestiko@pasok.gr
Bakakos P
No affiliation info available
Katostaras T
No affiliation info available
Gregorakos L
No affiliation info available

MeSH

APACHEAdolescentAdultAgedAged, 80 and overCross InfectionFemaleGreeceHumansIncidenceIntensive Care UnitsLength of StayMaleMiddle AgedOutcome Assessment, Health CarePneumoniaRespiration, ArtificialRisk Factors

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

12841859

Citation

Apostolopoulou, Eleni, et al. "Incidence and Risk Factors for Ventilator-associated Pneumonia in 4 Multidisciplinary Intensive Care Units in Athens, Greece." Respiratory Care, vol. 48, no. 7, 2003, pp. 681-8.
Apostolopoulou E, Bakakos P, Katostaras T, et al. Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece. Respir Care. 2003;48(7):681-8.
Apostolopoulou, E., Bakakos, P., Katostaras, T., & Gregorakos, L. (2003). Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece. Respiratory Care, 48(7), 681-8.
Apostolopoulou E, et al. Incidence and Risk Factors for Ventilator-associated Pneumonia in 4 Multidisciplinary Intensive Care Units in Athens, Greece. Respir Care. 2003;48(7):681-8. PubMed PMID: 12841859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece. AU - Apostolopoulou,Eleni, AU - Bakakos,Petros, AU - Katostaras,Theophanis, AU - Gregorakos,Leonides, PY - 2003/7/5/pubmed PY - 2003/12/5/medline PY - 2003/7/5/entrez SP - 681 EP - 8 JF - Respiratory care JO - Respir Care VL - 48 IS - 7 N2 - INTRODUCTION: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection among intensive care unit (ICU) patients. OBJECTIVE: Prospectively identify the factors associated with development of VAP and examine the incidence of VAP. SUBJECTS: Over a 6-month period we had 175 patients who required mechanical ventilation for longer than 24 hours. RESULTS: VAP occurred in 56 patients (32%). Stepwise logistic regression analysis identified 5 factors independently associated with VAP (p < 0.05): bronchoscopy (adjusted odds ratio [AOR] = 2.95; 95% confidence interval [CI], 1.1-8.3; p = 0.036); tube thoracostomy (AOR = 2.78; 95% CI, 1.1-6.6; p = 0.023); tracheostomy (AOR = 3.56; 95% CI, 1.7-8.4; p = 0.002); Acute Physiology and Chronic Health Evaluation (APACHE II) score >/= 18 (AOR = 2.33; 95% CI, 1.1-5.1; p = 0.033); and enteral feeding (AOR = 2.89; 95% CI, 1.3-7.7; p = 0.026). The duration of mechanical ventilation was longer among patients who developed VAP (p < 0.001). VAP was not associated with the cause of ICU admission. CONCLUSIONS: VAP is a common infection and certain interventions might affect the incidence of VAP. ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP and modifying patient care to minimize the risk of VAP, such as avoiding unnecessary bronchoscopy or modulating enteral feeding. SN - 0020-1324 UR - https://www.unboundmedicine.com/medline/citation/12841859/Incidence_and_risk_factors_for_ventilator_associated_pneumonia_in_4_multidisciplinary_intensive_care_units_in_Athens_Greece_ DB - PRIME DP - Unbound Medicine ER -