12 October 2019 : Clinical Research
Risk Factors for Mortality Due to Ventilator-Associated Pneumonia in a Chinese Hospital: A Retrospective Study
Ding-Yun Feng1ABCDEFG, Yu-Qi Zhou1ACDF, Mi Zhou2BCD, Xiao-Ling Zou1BDF, Yan-Hong Wang1BD, Tian-Tuo Zhang1AEFG*DOI: 10.12659/MSM.916356
Med Sci Monit 2019; 25:7660-7665
Abstract
BACKGROUND: As a common nosocomial infection, ventilator-associated pneumonia (VAP) often has high mortality. This study aimed to assess the risk factor for mortality owing to VAP.
MATERIAL AND METHODS: This retrospective clinical audit study screened medical records between the period of January 2014 and December 2017. All patients under mechanical ventilation MV) for ≥72 hours were screened against previously reported diagnostic criteria for VAP. The medical records were obtained for cases of documented diagnosis of VAP.
RESULTS: In all, 145 patients (5.0%) diagnosed with VAP were included in the study; the morbidity of VAP was 19.5 episodes per 1000 days of MV. The 30-day mortality rate was 42.8%. Univariate logistic analysis showed that elevated neutrophil-to-lymphocyte ratio (NLR), high blood urea nitrogen/albumin (BUN/ALB) ratio, Multidrug-resistant organism infection, and a higher sequential organ failure assessment (SOFA) score were risk factors for mortality caused by VAP. In the second multivariate analysis, elevated NLR levels (P=0.038), high BUN/ALB ratio (P=0.016), multidrug-resistant organism infections (P=0.036), and a higher SOFA score (P<0.001) were still associated with the 30-day mortality rate.
CONCLUSIONS: The 30-day mortality rate of VAP was high. Blood NLR and BUN/ALB levels can be used as risk factors to assess the 30-day VAP-related mortality to help clinicians improve the prognosis of VAP.
Keywords: Mortality, Pneumonia, Ventilator-Associated, Risk Factors, Hospitals, Incidence, Logistic Models
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