Abstract
Introduction: The Centers for Disease Control and Prevention proposed a new surveillance definition of ventilator-associated event (VAE). We investigated risk factor and prognosis of VAE.
Method: We performed a retrospective review of medical records of patients admitted to two mixed intensive care units from January 2013 through June 2014. Patients who were less than 18 years or dependent on mechanical ventilation (MV) less than 2 calendar days were excluded. Binary logistic regression was employed to evaluate risk factors and prognostic significance of VAE.
Results: Among 1034 episodes of MV, there were 93 (9.0%) ventilator-associated conditions, 35 (3.5%) infection-related ventilator-associated complications, 11 (1.1%) possible ventilator associated pneumonias and 19 (1.8%) probable ventilator associated pneumonias. Median onset time VAE from start of MV was 5 days. Baseline characteristics of MV with or without VAE were similar. 61 (65.6%) episodes of MV with VAE and 581 (61.7%) MV without VAE occurred in male. Median age of MV with or without VAE was 69 and 67 years, respectively. Mean Charlson Comorbidity Index was 2.28 and 1.94 in MV with or without VAE. Etiologies of MV including respiratory sepsis (OR 2.132, 95% CI 1.290-3.523), trauma (OR 3.384, 95% CI 1.412-8.109) and pulmonary edema (OR 3.505, 95% CI 1.656-7.420) were significant risk factors of VAE. VAE was associated mortality and extubation rate. In hospital 90-day mortality was higher in MV with VAE than without VAE (OR 6.370, 95% CI 3.765-10.780). Extubation rate was lower in MV with VAE than without VAE (OR 0.164, 95% CI 0.087-0.309).
Conclusion: The occurrence of VAE was affected by the cause of respiratory failure and related with poor patient outcomes.
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