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Observational Study
. 2022 Jul;57(7):1635-1642.
doi: 10.1002/ppul.25929. Epub 2022 Apr 26.

RISK score for developing ventilator-associated pneumonia in children: The RISVAP study

Mònica Girona-Alarcón  1   2   3 , Sara Bobillo-Perez  1   2 , Anna Solé-Ribalta  1   2   3 , Daniel Cuadras  4 , Carmina Guitart  1   2 , Mònica Balaguer  1   2 , Francisco-José Cambra  1   2 , Iolanda Jordan  1   2   5
Affiliations
Observational Study

RISK score for developing ventilator-associated pneumonia in children: The RISVAP study

Mònica Girona-Alarcón et al. Pediatr Pulmonol. 2022 Jul.

Abstract

Objectives: Ventilator-associated pneumonia (VAP) is the second most common healthcare-associated infection in children. The aim of this study was to determine the risk factors for VAP in children and to create a risk score for developing VAP (RISVAP score).

Study design: It was a prospective observational study, including children who required mechanical ventilation (MV), registered in the multicentre ENVIN-HELICS database from 2014 to 2019. The regression coefficients of each independent risk factor for VAP were used to create the RISVAP score. Each factor scored 0 if it was absent, or, if it was present, an assigned value from 1 to 7, according to the regression coefficient.

Results: A total of 3798 patients were included, 97(2.5%) developing VAP. The independent risk factors for VAP were: female (odds ratio [OR]: 1.642, p = 0.024), MV > 4 days (OR: 26.79, p < 0.001), length in pediatric intensive care unit > 7 days (OR: 11.74, p < 0.001), and previous colonisation (OR: 4.18, p < 0.001). The RISVAP was calculated for each patient as the sum of all the independent risk factors. Three risk groups were obtained: low (0-5 points), intermediate (6-12 points), and high risk for VAP (13-16 points). The area under the curve for the final score was 0.905 (95%confidence interval: 0.888-0.923, p < 0.001).

Conclusions: The RISVAP is the first risk score for VAP in pediatric populations. Using this predictive score, might be helpful to detect vulnerable patients and therefore implement preventative strategies.

Keywords: healthcare-associated infection; intensive care; pediatrics; ventilator-associated pneumonia.

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References

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