Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 29;14(3):e23634.
doi: 10.7759/cureus.23634. eCollection 2022 Mar.

Trends and Factors Associated With Ventilator-Associated Pneumonia: A National Perspective

Harshil Shah  1 , Ahmed Ali  2 , Achint A Patel  3 , Vaidarshi Abbagoni  4 , Ruchir Goswami  5 , Ananth Kumar  6 , Felipe Velasquez Botero  7 , Elohor Otite  8 , Hardik Tomar  9 , Maheshkumar Desai  10 , Prakash Maiyani  11 , Hiteshkumar Devani  12 , Faraz Siddiqui  13 , Salman Muddassir  3
Affiliations

Trends and Factors Associated With Ventilator-Associated Pneumonia: A National Perspective

Harshil Shah et al. Cureus. .

Abstract

Background: Ventilator-associated pneumonia (VAP) is a hospital-acquired pneumonia that occurs more than 48 hours after mechanical ventilation. Studies showing temporal trends, predictors, and outcomes of VAP are very limited.

Objective: We used the National database to delineate the trends and predictors of VAP from 2009 to 2017.

Methods: We analyzed data from the Nationwide Inpatient Sample (NIS) for adult hospitalizations who received mechanical ventilation (MV) by using ICD-9/10-CM procedures codes. We excluded hospitalizations with length of stay (LOS) less than two days. VAP and other diagnoses of interest were identified by ICD-9/10-CM diagnosis codes. We then utilized the Cochran Armitage trend test and multivariate survey logistic regression models to analyze the data.

Results: Out of a total of 5,155,068 hospitalizations who received mechanical ventilation, 93,432 (1.81%) developed VAP. Incidence of VAP decreased from 20/1000 in 2008 to 17/1000 in 2017 with a 5% decrease. Patients who developed VAP had lower mean age (59 vs 61; p<0.001) and higher LOS (25 days vs. 12 days; p<0.001). In multivariable regression analysis, we identified that males, African Americans, teaching hospitals and co-morbidities like neurological disorders, pulmonary circulation disorders and electrolyte disorders are associated with the increased odds of developing VAP. VAP was also associated with higher rates of discharge to facilities and increased LOS.

Conclusion: Our study identified the trends along with the risk predictors of VAP in MV patients. Our goal is to lay the foundation for further in-depth analysis of this trend for better risk stratification and development of preventive strategies to reduce the incidence of VAP among MV patients.

Keywords: mechanical ventilation; outcomes; predictors; trends; ventilation associated pneumonia.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Incidence of ventilator-associated pneumonia in mechanically ventilated patients
Figure 2
Figure 2. Temporal trends of discharge disposition among MV patients developing VAP
MV=Mechanical Ventilation, VAP=Ventilator Associated Pneumonia
Figure 3
Figure 3. Temporal trends of discharge disposition among MV patients without VAP
MV=Mechanical Ventilation, VAP=Ventilator Associated Pneumonia
Figure 4
Figure 4. Temporal trends of length of stay in MV patients by VAP
MV=Mechanical Ventilation, VAP=Ventilator Associated Pneumonia
See this image and copyright information in PMC

References

    1. Ventilator associated pneumonia and infection control. Alp E, Voss A. Ann Clin Microbiol Antimicrob. 2006;5:7. - PMC - PubMed
    1. Ventilator-associated pneumonia in the ICU. Kalanuria AA, Ziai W, Mirski M. Crit Care. 2014;18:208. - PMC - PubMed
    1. Prevention of ventilator-associated pneumonia in adults. Chulay M. Crit Care Nurse. 2017;37:0–5. - PubMed
    1. Outcome of ventilator-associated pneumonia: impact of antibiotic therapy and other factors. Mariya Joseph N, Sistla S, Kumar Dutta T, Shankar Badhe A, Rasitha D, Chandra Parija S. Australas Med J. 2012;5:135–140. - PMC - PubMed
    1. Risk factors of ventilator-associated pneumonia in critically III patients. Wu D, Wu C, Zhang S, Zhong Y. Front Pharmacol. 2019;10:482. - PMC - PubMed

LinkOut - more resources