Analysis of Risk Factors for Early-onset Ventilator-associated Pneumonia in a Neurosurgical Intensive Care Unit: A Single-center Retrospective Study

Abstract

Background:Ventilator-associated pneumonia (VAP) is a severe infection among patients in the neurosurgery intensive care unit (NICU).Methods:We retrospectively evaluated risk factors for early-onset ventilator-associated pneumonia (EOVAP) from January 2019 to December 2019 at a NICU. A total of 89 NICU patients who were intubated within 48 hours of onset and whose mechanical ventilation time was longer than 7 days were enrolled. The enrolled patients had no history of chronic lung disease and no clinical manifestations of infection before intubation. Clinical data of patients were recorded, and the incidence of and risk factors for EOVAP were analyzed. Patients were also grouped by age (≥65 vs. <65 years) and whether they had received hypothermia treatment or not.Results:Among 89 mechanically ventilated patients (49 men and 40 women; median age 60.1±14.3 years), 40 patients (44.9%) developed EOVAP in 7 days and 14 patients (15.7%) had multidrug resistant bacteria. Binary logistic regression analysis indicated that older age (≥65years) (odds ratio [OR]: 0.267, 95% confidence interval [CI]: 0.101-0.709, P=0.008) and therapeutic hypothermia (OR: 0.235, CI: 0.075-0.738, p=0.013) were independent predictors of EOVAP. Levels of peripheral blood leukocytes, neutrophils and platelets were lower in the therapeutic hypothermia group than those that did not receive hypothermia treatment.Conclusions:This study found that older age (≥65years) and therapeutic hypothermia were independently associated with the risk of EOVAP in NICU patients.