The incidence and characteristics of ventilator-associated pneumonia in a regional nontertiary Australian intensive care unit: A retrospective clinical audit study

Watson, Kirsty; Reoch, Josephine; Heales, Luke; Fernando, Jeremy; Tan, Elise; Smith, Kendric C.; Austin, David N; Divanoglou, Anestis

doi:10.1016/j.aucc.2021.04.004

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…Finally, like previous work highlighting an in‐hospital mortality rate of NV‐HAP between 15% and 30%, 8,28 our in‐hospital mortality rate for NV‐HAP cases was 18.9%. This is of particular significance as recent work highlighted an in‐hospital mortality rate of 14.7% for ventilator‐associated pneumonia in regional Australia 5 . This confirms that NV‐HAP may have an equal, if not higher in‐hospital mortality rate than ventilator‐associated pneumonia in regional hospital settings.…”

Section: Discussionsupporting

confidence: 58%

“…This is of particular significance as recent work highlighted an in-hospital mortality rate of 14.7% for ventilator-associated pneumonia in regional Australia. 5 This confirms that NV-HAP may have an equal, if not higher in-hospital mortality rate than ventilator-associated pneumonia in regional hospital settings.…”

Section: Cases With Nv-hap Total Admissionssupporting

confidence: 55%

“…In addition, NV‐HAP costs more and has a comparative mortality rate to that of ventilator‐associated pneumonia, 4 highlighting the need for further research in this area. While recent work has reported the incidence of ventilator‐associated pneumonia within regional Australia, 5 there is very limited evidence of the incidence of NV‐HAP within Australian hospitals. More globally, the incidence of NV‐HAP is reported as 1.2 to 8.9 cases per 1000 patient‐days, 6 with a mortality rate of 13.9%–30% 2,3,7,8 .…”

Section: Introductionmentioning

confidence: 99%

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The incidence, characteristics and in‐hospital mortality of non‐ventilator‐associated hospital‐acquired pneumonia in regional Queensland: A retrospective descriptive study

Gardiner

Brown

Richardson

et al. 2022

Australian J Rural Health

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Objective:The aim of this study was to determine the incidence, characteristics and in-hospital mortality of non-ventilator-associated hospital-acquired pneumonia (NV-HAP) in a regional (Modified Monash Model 2) Australian hospital.Methods: All cases with NV-HAP were obtained from the Business Analysis and Decision Support (BADS) Unit between 1st January 2013 and 31st December 2018. Medical records were reviewed, and data pertaining to incidence, characteristics (age and gender), length of stay, co-morbidities (measured using the Charlson Comorbidity Index) and in-hospital mortality were extracted. Incidence rate was calculated as a proportion of NV-HAP cases per 1000 bed-days.Design: A retrospective study design was used to review all cases of NV-HAP between 1 January 2013 and 31 December 2018 at a single regional Australian hospital. Using the Modified Monash Model (MMM), our regional setting is classified as a regional centre (MMM-2).

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Section: Discussionsupporting

confidence: 58%

Section: Cases With Nv-hap Total Admissionssupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

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The incidence, characteristics and in‐hospital mortality of non‐ventilator‐associated hospital‐acquired pneumonia in regional Queensland: A retrospective descriptive study

Gardiner

Brown

Richardson

et al. 2022

Australian J Rural Health

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“…Our results show that the baseline characteristics (such as spontaneous bacterial peritonitis, PCT, pretransplant infection, and sex) between the two groups were asymmetric in both the TICU and SICU settings. Some studies suggest high PCT levels significantly correlated with increased incidences of VAP ( 23 ). To negate the differences in the patient for the non-random assignment, a propensity-matched analysis was performed.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of comprehensive unit-based safety program to prevent ventilator associated-pneumonia for mechanically ventilated patients in China: A propensity-matched analysis

Wei

Zhou

et al. 2022

Front. Public Health

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BackgroundVentilator-associated pneumonia (VAP) is the most common healthcare-associated infection (HAI) in patients with mechanical ventilation. VAP is largely preventable, and a comprehensive unit-based safety program (CUSP) has effectively reduced HAI. In this study, we aim to comprehensively investigate the effect of implementing the CUSP in patients requiring mechanical ventilation.MethodsIn this uncontrolled before-and-after trial conducted in two intensive care unit (ICU) settings in China, patients requiring invasive mechanical ventilation were enrolled. Patients were divided into two groups based on the implementation of CUSP. The primary outcome was the incidence of VAP. The secondary outcomes were the time from intubation to VAP, days of antibiotic use for VAP treatments, rate of other infection, length of stay (LOS) in ICU, hospital LOS, and safety culture score. Joinpoint regression analysis was used to test the changes in trends of VAP rate for statistical significance. Propensity score matching (1:1 matching) was used to reduce the potential bias between CUSP and no CUSP groups. Univariate and multivariate logistic/linear regression analyses were performed to evaluate the association between the use of CUSP and clinical outcomes. This study was registered at the Chinese Clinical Trial Registry (chictr.org.cn), registration number: ChiCTR1900025391.ResultsA total of 1,004 patients from the transplant ICU (TICU) and 1,001 patients from the surgical ICU (SICU) were enrolled in the study from January 2016 to March 2022. Before propensity score matching, the incidences of VAP decreased from 35.1/1,000 ventilator days in the no CUSP group to 12.3/1,000 ventilator days in the CUSP group in the TICU setting (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15–0.59). The results of the joinpoint regression analysis confirmed that the implementation of CUSP significantly decreased the incidences of VAP. After propensity score matching in TICU setting, the CUSP group reported a lower incidence of VAP (30.4 vs. 9.7‰, P = 0.003; adjusted OR = 0.26, 95% CI: 0.10–0.76), lower wound infection (3.4 vs. 0.9%, P = 0.048; adjusted OR = 0.73, 95% CI: 0.50–0.95), shorter ICU LOS [3.5(2.3–5.3) vs. 2.5(2.0–4.5) days; P = 0.003, adjusted estimate = −0.34, 95% CI: −0.92 to −0.14], and higher safety culture score (149.40 ± 11.74 vs. 153.37 ± 9.74; P = 0.002). Similar results were also observed in the SICU setting between the no CUSP and CUSP group.ConclusionsThe implementation of CSUP for patients receiving mechanical ventilation could significantly reduce the incidences of VAP, and other infections, prolong the time until the VAP occurrence, reduces the days of antibiotic use for VAP, shorten the ICU and hospital LOS, and enhance the awareness of safety culture.

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Identifying the barriers and facilitators to implementation of ventilator bundle in the nepalese intensive care unit: A descriptive qualitative study

Thapa

Liu

Yang

et al. 2024

Australian Critical Care

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The incidence and characteristics of ventilator-associated pneumonia in a regional nontertiary Australian intensive care unit: A retrospective clinical audit study

Cited by 5 publications

References 35 publications

The incidence, characteristics and in‐hospital mortality of non‐ventilator‐associated hospital‐acquired pneumonia in regional Queensland: A retrospective descriptive study

The incidence, characteristics and in‐hospital mortality of non‐ventilator‐associated hospital‐acquired pneumonia in regional Queensland: A retrospective descriptive study

Efficacy of comprehensive unit-based safety program to prevent ventilator associated-pneumonia for mechanically ventilated patients in China: A propensity-matched analysis

Identifying the barriers and facilitators to implementation of ventilator bundle in the nepalese intensive care unit: A descriptive qualitative study

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