Evaluation of risk factors of ventilator associated pneumonia on outcome of acute exacerbation of chronic obstructive pulmonary disease

Abstract

Background: Ventilator associated pneumonia (VAP) remains an area of active clinical research with little data about effect of (VAP) on outcome among patients with acute exacerbation of chronic obstructive pulmonary disease.Materials and methods: A prospective study included patients with COPD exacerbation requiring endotracheal intubation for more than 48 h. Clinical assessment and Quantitative culture done for all patients for the occurrence of VAP.Results: Out of one hundred fifty two patients 92 patients (60.5%) were with VAP diagnosis. Their mean age was 56.1 ± 15.02 (38 cases developed early while 54 cases developed late VAP). Forty eight cases were discharged (54%) while 44 cases (46%) died. In comparing mean age of both groups 45.08 ± 15.52 and 57.41 ± 16.34 with P value 0.003. Prolonged use of antibiotics, reintubation and steroid use are possible risk factors for VAP with significant P values 0.03, 0.001, 0.05 respectively. Age above vs. below 60 showed adjusted odds ratio 5.33; 95% confidence interval 1.59-7.83 with P value 0.007. Early vs. late VAP, and prolonged use of antibiotics vs. none showed significant odds ratio 0.32; 95% CI 0.13-0.76, odds ratio 2.85; 95% CI 1.07-7.59 with P values 0.01, 0.04 respectively.Conclusions: Old age, late onset VAP, re-intubation and prolonged use of antibiotics were predictors of mortality in VAP patients with AECOPD.

Factores De Riesgo Dependientes Del Huésped Para Neumonía Asociada a Ventilador en La Uci Del Hospital Nacional Dos De Mayo Enero 2013 - Enero 2015

“…La edad avanzada (≥ 60años) mostró un odds ratio de 1.017 (IC 95% 0.386-2.677), lo cual nos permite afirmar que la edad avanzada tiene tendencia a ser un factor de riesgo para NAV, pero esta asociación no alcanza significancia estadística en el presente estudio. Lo hallado concuerda con lo encontrado por Neiva Acosta et al 23 ; no obstante difiere a lo encontrado por Badawy M.Sh et al 12 .…”

Effect of chronic obstructive pulmonary disease combined with ventilator‑associated pneumonia on patient outcomes: A systematic review and meta‑analysis

“…A total of six studies were excluded, as they did not fulfill the inclusion criteria. Finally, 7 studies were included in this systematic review and meta-analysis (1,(11)(12)(13)(14)(15)(16).…”

“…4). (11)(12)(13)(14) assessed the impact of VAP on outcomes of patients with COPD. Details of these studies are presented in Table III.…”

“…Details of these studies are presented in Table III. Of these, 3 were prospective studies (11)(12)(13), while one was a retrospective study (14). The sample size of the VAP arm varied from 35 to 92 patients and the sample size of the non-VAP arm varied from 60 to 318.…”

A review of abstracts on pneumonia published at abstract books of the 24th Russian Congress on Respiratory Diseases and the 24th Annual Congress of the European Respiratory Society

“…В Египте было проведено исследо вание у больных ВАП (n = 92), страдающих ХОБЛ. Установлено, что факторами, способствующими ле тальному исходу, оказались пожилой возраст, позд нее начало ВАП, реинтубация, длительный прием АБП [55].…”