Risk Factors and Prognostic Predictors of VentilatorAssociated Pneumonia in a Tertiary Care Hospital

Abstract

Introduction: It was aimed to evaluate the risk factors for the development of ventilator-associated pneumonia (VAP) and clinical outcomes and prognostic predictors of VAP. Materials and Methods: This retrospective and single-center study included patients aged ≥18 years who were diagnosed with VAP in the ICU. Patients were divided into two groups with VAP or without VAP. Univariable and multivariable analyses were used to assess risk factors and prognostic predictors of VAP. Results: A total of 177 patients were evaluated. Mean length of intensive care unit (ICU) stay and the duration of mechanical ventilation was longer in patients with VAP than in patients without VAP [29 (3-107) vs. 12 (3-70) days, 22 (3-90) vs. 10 (3-45) days; p< 0.001]. Rectal colonization with carbapenem-resistant Klebsiella pneumoniae (CRKp) was found to be higher in the VAP group compared to the non-VAP group (n= 41, 58% vs. n= 25, 24%, p< 0.001). Ventilation period (OR= 1.07; 95% CI 1.02-1.12, p= 0.003), smoking (OR= 3.89; 95% CI 1.68-8.9, p= 0.001), and rectal colonization with CRKp (OR= 4.93; 95% CI 2.09-11.64, p< 0.001) were detected as independent risk factors for the development of VAP. Age (OR= 1.15; 95% CI 1.03-1.28, p= 0.01), SOFA score (OR= 1.60; 95% CI 1.05-2.43, p= 0.02) and rectal colonization with CRKp (OR= 15.2; 95% CI 2.33-99.01, p= 0.004) were detected as independent risk factors for mortality in patients with VAP. Conclusion: In conclusion, decreasing the patient-related and hospital environment related risk factors, routine screening of rectal colonizations with CRKp, and continuous practicing of the universal infection control measures may significantly decrease the prevalence of ventilator-associated pneumonia.