Is a Low Incidence Rate of Ventilation Associated Pneumonia Associated with Lower Mortality? a Descriptive Longitudinal Study in Iran

Authors

1 Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

2 Department of Infectious Disease, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences,Tehran, Iran,

3 Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran,

4 Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran,

5 5 Department of Critical Care Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

6 Anesthesiology and Critical Care Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

7 Department of Critical Care Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

8 Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran,

9 Department of Anesthesiology and Critical Care, Anesthesiology Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Ventilator-Associated Pneumonia (VAP) is an important cause of
morbidity and mortality in patients admitted to Intensive Care Unit (ICU). The
current study conducted to estimate VAP incidence, attributable mortality and
case fatality rate, cost, so related factors can affect the outcome in patients.
Materials and Methods: In this descriptive longitudinal study, demographic,
clinical and para-clinical data were collected and attributable mortality and case
fatality rate was estimated. Multivariable analysis was done to predict the
possible risk factors on the outcome of VAP patients. Also, patients' survival
curve was plotted based on their length of ICU stay. Finally, the additional cost
due to VAP in ICU was estimated.
Results: Totally, 8% ICU admissions were affected by VAP and 4% expired
during the ICU stay. Further, the attributable mortality rate of VAP was high as
compared with standard mortality rate. The most case fatality rate was for
Acinetobacter sp. (n=17 60.7%). In multivariable logistic regression analysis, age
greater than 40 years, more than 96 hours mechanical ventilation and
uncontrolled diabetes mellitus were predictor factors of higher mortality.
Inverse association between survival time and ICU length of stay was reported.
Finally, the additional cost of VAP was estimated of about 700 US$ per patients.
Conclusion: According to the results, strategies to prevent mortality by
reducing the duration of ventilation and ICU length of stay should be
performed. Also, mandatory fees for the family and the healthcare system
should be planned.

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