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. 2018;9(3):203-210.
doi: 10.5847/wjem.j.1920-8642.2018.03.007.

Risk factors for ventilator-associated pneumonia in trauma patients: A descriptive analysis

Suresh Kumar Arumugam  1 , Insolvisagan Mudali  1 , Gustav Strandvik  1 , Ayman El-Menyar  2   3 , Ammar Al-Hassani  1 , Hassan Al-Thani  1
Affiliations

Risk factors for ventilator-associated pneumonia in trauma patients: A descriptive analysis

Suresh Kumar Arumugam et al. World J Emerg Med. 2018.

Abstract

Background: We sought to evaluate the risk factors for developing ventilator-associated pneumonia (VAP) and whether the location of intubation posed a risk in trauma patients.

Methods: Data were retrospectively reviewed for adult trauma patients requiring intubation for > 48 hours, admitted between 2010 and 2013. Patients' demographics, clinical presentations and outcomes were compared according to intubation location (prehospital intubation [PHI] vs. trauma room [TRI]) and presence vs. absence of VAP. Multivariate regression analysis was performed to identify predictors of VAP.

Results: Of 471 intubated patients, 332 patients met the inclusion criteria (124 had PHI and 208 had TRI) with a mean age of 30.7±14.8 years. PHI group had lower GCS (P=0.001), respiratory rate (P=0.001), and higher frequency of head (P=0.02) and chest injuries (P=0.04). The rate of VAP in PHI group was comparable to the TRI group (P=0.60). Patients who developed VAP were 6 years older, had significantly lower GCS and higher ISS, head AIS, and higher rates of polytrauma. The overall mortality was 7.5%, and was not associated with intubation location or pneumonia rates. In the early-VAP group, gram-positive pathogens were more common, while gram-negative microorganisms were more frequently encountered in the late VAP group. Logistic regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the models.

Conclusion: In trauma, the risk of developing VAP is multifactorial. However, the location of intubation and presence of chest injury could play an important role.

Keywords: Intensive care unit; Intubation location; Mechanical ventilation; Trauma; Ventilator-associated pneumonia.

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Figures

Figure 1
Figure 1
Comparison of early versus late VAP (P<0.05).
See this image and copyright information in PMC

References

    1. Kalanuria AA, Ziai W, Mirski M. Ventilator-associated pneumonia in the ICU. Crit Care. 2014;18:208. - PMC - PubMed
    1. Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R, Tablan OC, et al. Guidelines for preventing health-care--associated pneumonia 2003:recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004;53(RR-3):1–36. - PubMed
    1. Dudeck MA, Weiner LM, Allen-Bridson K, Malpiedi PJ, Peterson KD, Pollock DA, et al. National Healthcare Safety Network (NHSN) report, data summary for 2012, Device-associated module. Am J Infect Control. 2013;41(12):1148–66. - PMC - PubMed
    1. Mangram AJ, Sohn J, Zhou N, Hollingworth AK, Ali-Osman FR, Sucher JF, et al. Trauma-associated pneumonia:time to redefine ventilator-associated pneumonia in trauma patients. Am J Surg. 2015;210:1056, 61. discussion: 1061-2. - PubMed
    1. Magnotti LJ, Croce MA, Fabian TC. Is ventilator–associated pneumonia in trauma patients an epiphenomenon or a cause of death? Sur Infect (Larchmt) 2004;5:237–42. - PubMed

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