Purpose: Ventilator-associated pneumonia (VAP) is the main infectious complication in cardiac surgery patients and is associated with an important increase in morbidity and mortality. The aim of our study was to analyze the impact of VAP on mortality excluding other comorbidities and to study its etiology and the risk factors for its development.
Materials And Methods: This prospective cohort study included 1610 postoperative cardiac surgery patients' status post cardiopulmonary bypass (CPB) between July 2004 and January 2008. The primary outcome measures were the development of VAP and in-hospital mortality.
Results: Ventilator-associated pneumonia was observed in 124 patients (7.7%). Patients with VAP had a longer length of hospitalization (40.7 ± 35.1 vs 16.1 ± 30.1 days, P < .0001) and greater in-hospital mortality (49.2% [61/124] vs 2.0% [30/1486], P = .0001) in comparison with patients without VAP. After performing the Cox multivariant analysis adjustment, VAP was identified as the most important independent mortality risk factor (adjusted hazard ratio [HR], 8.53; 95% confidence interval, 4.21-17.30; P = .0001). Other independent risk factors of in-hospital mortality were chronic renal failure (HR, 2.56), diabetes mellitus (HR, 1.90), CPB time (HR, 1.51), respiratory failure (HR, 2.13), acute renal failure (HR, 2.39), and mediastinal bleeding of at least 1000 mL (HR, 1.81).
Conclusions: The development of VAP after CPB is the most important independent risk factor for in-hospital mortality. Identification of effective strategies for the prevention of VAP is needed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcrc.2011.03.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Carbapenem-resistant and Ventilator-associated Pneumonia; Epidemiology, Risk Factors, and Current Therapeutic Approaches.
J Res Pharm Pract
December 2024
Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran.
is one of the primary pathogens responsible for healthcare-associated infections. It is related to high rates of morbidity and mortality globally, mainly because of its high capacity to develop resistance to antimicrobials. Nowadays, carbapenem-resistant (CRAB) has increased and represents a significant concern among carbapenem-resistant organisms.
View Article and Find Full Text PDFFrequency and Patterns of Multidrug-Resistant Organisms among Ventilated Patients During the Coronavirus Disease-19 Pandemic.
J Coll Physicians Surg Pak
January 2025
Department of Pathology, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Objective: To determine the frequency of multidrug-resistant (MDR) bacterial isolates in respiratory specimens obtained from ventilated patients admitted to critical care units at the National Institute of Cardiovascular Diseases (NICVD), along with COVID-19-positive cases.
Study Design: An observational study. Place and Duration of the Study: National Institute of Cardiovascular Diseases, between November 2021 and March 2022.
Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.
Crit Care
January 2025
Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.
Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.
Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.
Comparison of Multi-Drug Resistant Organisms Causing Early Ventilator-Associated Pneumonia in Three Geographically Distinct Trauma Intensive Care Units.
Surg Infect (Larchmt)
January 2025
Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
It is unclear why differences in patient location change organisms causing ventilator-associated pneumonia (VAP). We investigated VAP organisms in three geographically separate trauma intensive care units (TICUs). A retrospective review of organisms causing VAP (bronchoalveolar lavage [BAL] performed ≤7 d after admission and growing ≥10 cfu/mL) in three geographically separate TICUs was conducted.
View Article and Find Full Text PDFEmpirical antibiotic therapy improves outcomes in mechanically ventilated patients with COVID-19: An emulated targeted trial within a prospective, multicentre cohort study.
J Infect
January 2025
Department of Critical Care Medicine, Hospital Verge de la Cinta, Tortosa, Pere Virgili Institute for Health Research, Spain.
Background: Bacterial pulmonary superinfections develop in a substantial proportion of mechanically ventilated COVID-19 patients and are associated with prolonged mechanical ventilation requirements and an increased mortality. Albeit recommended, evidence supporting the use of empirical antibiotics at intubation is weak and of low quality. The aim of this study was to elucidate the effect of empirical antibiotics, administered within 24hours of endotracheal intubation, on superinfections, duration of mechanical ventilation, and mortality in mechanically ventilated patients with COVID-19.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!