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Impact of ventilator-associated pneumonia on mortality and epidemiological features of patients with secondary peritonitis.

Heredia-Rodríguez M, Peláez MT, Fierro I, Gómez-Sánchez E, Gómez-Pesquera E, Lorenzo M, Álvarez-González FJ, Bustamante-Munguira J, Eiros JM, Bermejo-Martin JF, Gómez-Herreras JI, Tamayo E - Ann Intensive Care (2016)

Bottom Line: Univariate and multivariate analyses were performed to identify risk factors associated with mortality and development of VAP.The 90-day in-hospital mortality rate was 47.5 % of VAP patients.Independent factors associated with 30- to 90-day in-hospital mortality were VAP and SOFA.

View Article: PubMed Central - PubMed

Affiliation: Anaesthesiology and Surgical Critical Care Department, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal, 3, 47005, Valladolid, Spain. maria_her_05@hotmail.com.

ABSTRACT

Background: Despite the significant impact of nosocomial infections on the morbidity and mortality of patients staying in the intensive care unit (ICU), no study over the past 20 years has focused specifically on VAP following secondary peritonitis. The objective of the present study was to determine in-hospital mortality and epidemiological features attributed to ventilator-associated pneumonia (VAP) following secondary peritonitis.

Methods: Prospective observational study involved 418 consecutive patients admitted in the ICU. Univariate and multivariate analyses were performed to identify risk factors associated with mortality and development of VAP.

Results: The incidence of VAP following secondary peritonitis was 9.6 %. Risk factors associated with the development of VAP were hospital-acquired peritonitis, requiring >48 h of mechanical ventilation, and SOFA score. The onset of VAP was late in majority of patients. VAP was developed about 16.8 days after the initiation of the peritonitis. Etiological microorganisms responsible for the peritonitis were different than for VAP. The 90-day in-hospital mortality rate was 47.5 % of VAP patients. Independent factors associated with 30- to 90-day in-hospital mortality were VAP and SOFA.

Conclusions: In light of the impact on morbidity and mortality in the ICU, more attention should be given to the concurrent features among VAP and secondary peritonitis.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier analysis showing the percentage of survival between patients with and without ventilator-associated pneumonia
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Fig1: Kaplan–Meier analysis showing the percentage of survival between patients with and without ventilator-associated pneumonia

Mentions: Mortality at 30 days was not different between groups and however at 90 days was significantly higher (p = 0.008) in VAP patients (45.0 %) than in non-VAP (5.8 %). Kaplan–Meier survival analysis revealed that the percentage of survival was different between VAP and non-VAP patients (log rank = 5.289; p = 0.021; Fig. 1), indicating higher values for non-VAP patients. Both survival curves diverged after the day 40th of admission in the ICU.Fig. 1


Impact of ventilator-associated pneumonia on mortality and epidemiological features of patients with secondary peritonitis.

Heredia-Rodríguez M, Peláez MT, Fierro I, Gómez-Sánchez E, Gómez-Pesquera E, Lorenzo M, Álvarez-González FJ, Bustamante-Munguira J, Eiros JM, Bermejo-Martin JF, Gómez-Herreras JI, Tamayo E - Ann Intensive Care (2016)

Kaplan–Meier analysis showing the percentage of survival between patients with and without ventilator-associated pneumonia
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835417&req=5

Fig1: Kaplan–Meier analysis showing the percentage of survival between patients with and without ventilator-associated pneumonia
Mentions: Mortality at 30 days was not different between groups and however at 90 days was significantly higher (p = 0.008) in VAP patients (45.0 %) than in non-VAP (5.8 %). Kaplan–Meier survival analysis revealed that the percentage of survival was different between VAP and non-VAP patients (log rank = 5.289; p = 0.021; Fig. 1), indicating higher values for non-VAP patients. Both survival curves diverged after the day 40th of admission in the ICU.Fig. 1

Bottom Line: Univariate and multivariate analyses were performed to identify risk factors associated with mortality and development of VAP.The 90-day in-hospital mortality rate was 47.5 % of VAP patients.Independent factors associated with 30- to 90-day in-hospital mortality were VAP and SOFA.

View Article: PubMed Central - PubMed

Affiliation: Anaesthesiology and Surgical Critical Care Department, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal, 3, 47005, Valladolid, Spain. maria_her_05@hotmail.com.

ABSTRACT

Background: Despite the significant impact of nosocomial infections on the morbidity and mortality of patients staying in the intensive care unit (ICU), no study over the past 20 years has focused specifically on VAP following secondary peritonitis. The objective of the present study was to determine in-hospital mortality and epidemiological features attributed to ventilator-associated pneumonia (VAP) following secondary peritonitis.

Methods: Prospective observational study involved 418 consecutive patients admitted in the ICU. Univariate and multivariate analyses were performed to identify risk factors associated with mortality and development of VAP.

Results: The incidence of VAP following secondary peritonitis was 9.6 %. Risk factors associated with the development of VAP were hospital-acquired peritonitis, requiring >48 h of mechanical ventilation, and SOFA score. The onset of VAP was late in majority of patients. VAP was developed about 16.8 days after the initiation of the peritonitis. Etiological microorganisms responsible for the peritonitis were different than for VAP. The 90-day in-hospital mortality rate was 47.5 % of VAP patients. Independent factors associated with 30- to 90-day in-hospital mortality were VAP and SOFA.

Conclusions: In light of the impact on morbidity and mortality in the ICU, more attention should be given to the concurrent features among VAP and secondary peritonitis.

No MeSH data available.


Related in: MedlinePlus