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Observational Study
. 2025 Oct 21;25(1):1363.
doi: 10.1186/s12879-025-11341-3.

Epidemiology of ventilator associated events in intubated patients: a multicenter observational study

Esma Eryılmaz Eren  1 , Duygu Mert  2 , Fatma Eser  3 , Seniha Senbayrak  4 , Gamze Kalın  5 , Gulden Eser Karlıdag  6 , Tugce Simsek Bozok  7 , Fatma Yekta Urkmez  8 , Tuba Ilgar  9 , Canan Demir  10 , Secil Deniz  11 , Derya Ozyigitoglu  12 , Nefise Oztoprak  13 , Safak Kaya  14 , Meltem Arzu Yetkin  15 , Yolanda Peña-López  16 , Jordi Rello  16 , Emine Alp Meşe  3 ; VAE Study Group
Collaborators, Affiliations
Observational Study

Epidemiology of ventilator associated events in intubated patients: a multicenter observational study

Esma Eryılmaz Eren et al. BMC Infect Dis. .

Erratum in

Abstract

Background: Ventilator-associated infectious complications are the most prevalent healthcare-acquired infection in intensive care units. The surveillance of ventilator-associated events (VAE) has now supplanted traditional ventilator-associated pneumonia (VAP) monitoring. However, its use is not common and limited reports have been published. We aimed to describe the epidemiology, etiology and the prognosis of VAE.

Methods: This multicenter observational-descriptive study was conducted at 15 centers with active prospective surveillance of VAE. Their daily basis follow-up was for 90 days. The Centers for Disease Control and Prevention guideline 2015 update was used for the definition of VAE. VAE subdiagnosis was defined as ventilator-associated condition (VAC), infection-related ventilator-associated complication plus (IVAC-plus), infection-related ventilator-associated complications (IVAC), and possible ventilator-associated pneumonia (PVAP) RESULTS: A total of 185 VAE episodes developed in 174 of the 1018 patients included in the study. The VAE incidences per 1000 mechanical ventilation day were; VAC 2.33, IVAC-plus 6.0, IVAC 1.3 and PVAP 4.7. Additionally 158 VAP episodes (14.8%, 7.09/1000 MV days) were observed, 85 (45.9%, 4.99/1000 MV days) of them fit the definition of a concurrent VAE criteria. Risk factors for VAE included a Sequential Organ Failure Assessment (SOFA) score greater than 7 on admission (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.23-2.47), the presence of a tracheostomy (OR:1.78; CI:1.19-2.65), and antibiotic use within the previous 90 days (OR:2.41; CI:1.09-4.20) were risk factors for VAE. The mortality rate was 59.6% in ventilated patients. Multivariate analysis identified several risk factors for mortality, as follows: age greater than 63 years (OR: 1.75; CI: 1.26-2.42), a SOFA score greater than 5 on admission (OR: 2.00; CI: 1.47-1.46), a higher mean Charlson Comorbidity Index (OR: 1.08; CI: 1.02-1.13), being a medical-type patient (OR: 1.54; CI: 1.06-2.21), healthcare-associated infections (OR: 2.01; CI: 1.39-2.88), and the occurrence of VAE (OR: 2.21; CI: 1.04-4.70).

Conclusion: VAE is a common complication in intubated patients and is 2.21 times more likely to occur in intubated patients who die. Patients with a high SOFA score, tracheostomy and antibiotic use in the last 90 days are at increased risk. prevention of VAE in intubated patients is important for patient survival.

Keywords: Healthcare-Associated Infections; Intensive Care; Intubated Patients; Mechanical Ventilation; Ventilator Associated Events; Ventilator Associated Pneumonia.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study is based on non-anonymized data from the infectious disease reporting system, but there are no conficts of interest between any of the authors and the individuals in the data and only the data analysts have access to the non-anonymized data.The clinical research was approved by the Kayseri City Hospital Clinical Research Ethics Committe (2022;764). The relevant ethics committee has decided that participation in the study does not require consent because infection control surveillance data is used. This study was conducted in conformity with the principles outlined in the Helsinki Declaration. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Diagnosis of ventilator associated events
Fig. 2
Fig. 2
A flowchart of included patients
Fig. 3
Fig. 3
Incidence of VAE (1000 MV days) from cities in the study
Fig. 4
Fig. 4
Episodes of ventilator associated events
See this image and copyright information in PMC

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