Risk Factors and Outcome in Patients with Ventilator Associated Pneumonia in ICU at CHUK

Abstract

Background: Ventilator associated pneumonia is linked to a high mortality rate, increased ICU stay and cost. Identification of risk factors may allow a cost-effective setting of preventive measures. Aim: To assess incidence; risk factors; outcome for VAP in ICU.

Method: Prospective cohort study, was conducted from January2022 to May 2022 on adult patients who underwent MV beyond 48 hours in ICU/CHUK.VAP was detected using CPIS. Incidence of VAP per 1000 ventilation-days was calculated. Logistic regression was done to pinpoint the predictors of mortality along with predictors of developing VAP. The compliance for triple bundle about VAP prevention was also evaluated for the development of VAP. Elements exhibiting close link with the outcome of interest (P<0.25) took place into multivariable logistic regression to pinpoint independent predictors to the outcome. P<0.05 expressed statistical significance. Result: About 153 participants, 74 arose at the minimum 1 event of Ventilator associated pneumonia in ICU. Incidence about ventilator associated pneumonia noted as 44 per 1,000ventilation-days. Female participants were more apparently more to have VAP (OR=3.1; 95%CI 1.38-7.03; P= 0.006) as opposed to male patients. The compliance with the triple bundle was higher among patients who do not acquire VAP than participants with VAP (63+/-16% versus 38+/-12%; p<0.001). Patients who received H2 antagonists are 6.75 times feasible to VAP compared to those who received PPIs. Of 74 patients with VAP, 36 (49%) died in ICU versus27 (34%) for those without. In binary logistic regression It coexists statistical significant in the mortality rate among, participants who have diabetes and those who did not have diabetes (OR=3.64; 95%CI: 1.30-10.18; P=0.014).and All the patients who had HIV comorbidity died compared to 39% of those without HIV (p=0.003). The multivariable logistic regression done to pick out independent factors for mortality and revealed that patients with diabetes mellitus were more presumably to die (odd ratio =3.30, 95% confident interval: 1.169.35; P=0.024). It coexists a significant difference in ICU stay for cases with VAP than nonventilator associated pneumonia (P=0.0162 with median (QI-Q3) ICU stay of 8(5-11) days for non VAP and 9(6-14) for VAP. Conclusion: The incidence of VAP is high. However, an implementation of preventive measures including PPIs’ prescription may alleviate their incidence.