FACTORS ASSOCIATED WITH DEATH IN INTENSIVE CARE UNIT PATIENTS HAVING VENTILATOR ASSOCIATED PNEUMONIA

Slobodan M Janković; Zorana Djordjevic

doi:10.5937/sjecr13-2669

Slobodan M Janković Faculty of Medical Sciences, University of Kragujevac
Zorana Djordjevic Clinical Center Kragujevac, Serbia

DOI: https://doi.org/10.5937/sjecr13-2669

Abstract

Background. The incidence of ventilator-associated pneumonia (VAP) among patients on mechanical ventilation is from 15% to 25%, and mortality ranges from 33% to 38%.

Aim. The aim of our study was to analyze importance of previously un-investigated potential risk factors for death in intensive care unit (ICU) patients with VAP.

Methods. A cross-sectional design was chosen for this study. The study population consisted of all patients who developed ventilator associated pneumonia in the central ICU of a tertiary care hospital (n = 65) during the period of 6 months. Cases (n=45) were patients who died during their treatment in the ICU, if their primary cause of death was ventilator associated pneumonia. Controls (n=20) were patients with VAP who survived their treatment in the ICU, and were transferred to other hospital wards.

Results. Significant associations were found between death and age over 65 (OR_adjusted 10.66; CI 1.22, 93.12; p = 0.032), death and hospitalization at another hospital ward prior to ICU (OR_adjusted 1.25; CI 1.03, 1.52; p = 0.28), death and infection on admission to ICU (OR_adjusted 434.39; CI 3.07, 61449.65; p = 0.016), and death and administration of ceftriaxone prior to VAP (OR_adjusted 69.32; 1.74, 2768.92; p = 0.024). Synergistic effect on death was found only for age over 65 and infection on admission to ICU.

Conclusions. The ICU patients with VAP have increased mortality if they receive ceftriaxone prophylactically, if they have an infection at admission to ICU and when their age is advanced.

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