Decreasing incidence and mortality among hospitalized patients suffering a ventilator-associated pneumonia

Miguel-Díez, Javier de; López‐de‐Andrés, Ana; Hernández-Barrera, Valentín; Jiménez‐Trujillo, Isabel; Méndez‐Bailón, Manuel; Miguel‐Yanes, José M. de; Rio-Lopez, Benito del; Jiménez‐García, Rodrigo

doi:10.1097/md.0000000000007625

Cited by 24 publications

(17 citation statements)

References 42 publications

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“…In agreement with other studies [47][48][49][50], the current study showed a male sex predominance. The age of the study patients was higher in the non-survivors group.…”

Section: Discussionsupporting

confidence: 93%

Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia

et al. 2021

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Background Ventilator-associated pneumonia (VAP) is the most common nosocomial infection. Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are prognostic factors to mortality in different diseases. The aim of this study is to evaluate prognostic efficiency RDW, NLR, and the Sequential Organ Failure Assessment (SOFA) score for mortality prediction in respiratory patients with VAP. Results One hundred thirty-six patients mechanically ventilated and developed VAP were included. Clinical characteristics and SOFA score on the day of admission and at diagnosis of VAP, RDW, and NLR were assessed and correlated to mortality. The average age of patients was 58.80 ± 10.53. These variables had a good diagnostic performance for mortality prediction AUC 0.811 for SOFA at diagnosis of VAP, 0.777 for RDW, 0.728 for NLR, and 0.840 for combined of NLR and RDW. The combination of the three parameters demonstrated excellent diagnostic performance (AUC 0.889). A positive correlation was found between SOFA at diagnosis of VAP and RDW (r = 0.446, P < 0.000) and with NLR (r = 0.220, P < 0.010). Conclusions NLR and RDW are non-specific inflammatory markers that could be calculated quickly and easily via routine hemogram examination. These markers have comparable prognostic accuracy to severity scores. Consequently, RDW and NLR are simple, yet promising markers for ICU physicians in monitoring the clinical course, assessment of organ dysfunction, and predicting mortality in mechanically ventilated patients. Therefore, this study recommends the use of blood biomarkers with the one of the simplest ICU score (SOFA score) in the rapid diagnosis of critical patients as a daily works in ICU.

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“…In agreement with other studies [47][48][49][50], the current study showed a male sex predominance. The age of the study patients was higher in the non-survivors group.…”

Section: Discussionsupporting

confidence: 93%

Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia

et al. 2021

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“…Juthani et al 16 found that male gender was a significant risk factor for CAP (HR 2.07; 95% CI 1.51‐2.83); however, other authors indicated that male gender is a nonsignificant factor for CAP 17 . Previous works have shown that despite the lower incidence of VAP, females with VAP have increased mortality 18 . Sharpe et al 19 found that despite a higher incidence of VAP amongst males (3.8% vs 2.6%, P = .001), mortality was higher in females (24% vs 15%, P = .009).…”

Section: Introductionmentioning

confidence: 99%

“…17 Previous works have shown that despite the lower incidence of VAP, females with VAP have increased mortality. 18 Sharpe et al 19 found that despite a higher incidence of VAP amongst males (3.8% vs 2.6%, P = .001), mortality was higher in females (24% vs 15%, P = .009).…”

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confidence: 98%

Gender differences in incidence and in‐hospital outcomes of community‐acquired, ventilator‐associated and nonventilator hospital‐acquired pneumonia in Spain

et al. 2020

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Aims We aim to compare the incidence and in‐hospital outcomes of community‐acquired pneumonia (CAP), ventilator‐associated pneumonia (VAP) and nonventilator hospital‐acquired pneumonia (NV‐HAP) according to gender. Methods This was a retrospective observational epidemiological study using the Spanish National Hospital Discharge Database for the years 2016 and 2017. Results Of 277 785 hospital admissions, CAP was identified in 257 455 (41.04% females), VAP was identified in 3261 (30.42% females) and NV‐HAP was identified in 17 069 (36.58% females). The incidence of all types of pneumonia was higher amongst males (CAP: incidence rate ratio [IRR] 1.05, 95% CI 1.03‐1.06; VAP: IRR 1.36, 95% CI 1.26‐1.46; and NV‐HAP: IRR 1.16, 95% CI 1.14‐1.18). The crude in‐hospital mortality (IHM) rate for CAP was 11.44% in females and 11.80% in males (P = .005); for VAP IHM, the rate was approximately 35% in patients of both genders and for NV‐HAP IHM, the rate was 23.97% for females and 26.40% for males (P < .001). After multivariable adjustment, in patients of both genders, older age and comorbidities were factors associated with IHM in the three types of pneumonia analysed. Female gender was a risk factor for IHM after VAP (OR 1.24; 95% CI 1.06‐1.44), and no gender differences were found for CAP or NV‐HAP. Conclusions Our findings show a difference between females and males, with females presenting a lower incidence of all types of pneumonia. However, female gender was a risk factor for IHM after VAP.

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“…Over the last two decades, research has focused mainly on ventilator-associated pneumonia (VAP), and as a consequence, the incidence of this complication has decreased and patient outcomes have improved [2–5]. In Spain, a recent investigation showed that the incidence rates of VAP improved significantly from 41.7 cases/100,000 inhabitants in 2010 to 40.55 cases/100,000 inhabitants in 2014 [6]. However, VAP is not the only form of HAP; a recent report with data from the US National Inpatient Sample dataset found that nonventilator HAP was associated with mortality, a greater length of hospital stay and an increase in the cost of care [7].…”

Section: Introductionmentioning

confidence: 99%

Type 2 diabetes and postoperative pneumonia: An observational, population-based study using the Spanish Hospital Discharge Database, 2001-2015

et al. 2019

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PurposeWe analyzed temporal trends, demographic and clinical characteristics and hospital mortality rates of postoperative pneumonia among type 2 diabetes mellitus (T2DM) patients in Spain from 2001 to 2015. We also compared the incidence, comorbidities and mortality between patients with and without T2DM suffering from postoperative pneumonia. Finally, we analyzed the factors involved in the prediction of in-hospital mortality among patients suffering postoperative pneumonia.MethodsWe used the Spanish National Hospital Discharge Database for the period 2001–2015. We analyzed patients aged 40 years or over who had been hospitalized for a surgical procedure and suffered pneumonia or ventilator-associated pneumonia during their hospital admission. We compared patients with and without T2DM. The main outcome measures were the type of surgical procedure, the presence of a comorbidity, the type of isolated pathogens, admission to the emergency room (ER) and in-hospital mortality (IHM).ResultsWe selected 117,665 hospitalized patients who suffered postoperative pneumonia (16.9% with T2DM). After multivariable adjustment, T2DM patients had a 21% higher incidence of postoperative pneumonia than nondiabetic patients (IRR 1.21, 95% CI 1.03–1.42). The IHM was approximately 31% in both groups. Predictors of IHM included age, the presence of comorbidities, treatment with a pleural drainage tube, dialysis, blood transfusion, mechanical ventilation and admission to the ER. From 2001 to 2015, the IHM decreased significantly in both populations. Suffering from T2DM was not a predictor of IHM (OR 0.99, 95% CI 0.96–1.03) in our investigation.ConclusionsT2DM patients have a higher incidence of postoperative pneumonia than those without this disease. The IHM decreased from 2001 to 2015, regardless of T2DM status. T2DM did not predict a higher IHM after suffering from postoperative pneumonia.

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Decreasing incidence and mortality among hospitalized patients suffering a ventilator-associated pneumonia

Abstract: Supplemental Digital Content is available in the text

Cited by 24 publications

References 42 publications

Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia

Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia

Gender differences in incidence and in‐hospital outcomes of community‐acquired, ventilator‐associated and nonventilator hospital‐acquired pneumonia in Spain

Type 2 diabetes and postoperative pneumonia: An observational, population-based study using the Spanish Hospital Discharge Database, 2001-2015

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