Publication:

A study of the correlation between ventilator associated pneumonia and mortality rate of traumatic in patients in intensive care units

Background Ventilator-associated pneumonia (VAP) is the most common nosocomial infection among the traumatic in-patients in Intensive Care Units (ICUs). Trauma is a risk factor for the incidence of VAP, yet, the association between VAP and outcome is not clear in traumatic in-patients in ICUs. This study investigated the correlation between ventilator-associated pneumonia and mortality rate of traumatic in-patients in ICUs in Be'that Hospital in Hamedan, western Iran.

Methods This observational prospective study was conducted in the ICU of Be'that Hospital, Hamedan, Iran, during 1 year (March 2013 until February 2014). The population under study included traumatic in-patients aged less than 18 year who were in need of invasive mechanical ventilation for more than 48 h with APACHE SCORE II of less than 25. They were studied for the incidence or lack of incidence of VAP.

Results Of 154 patients under study, 114 cases (74%) suffered from multiple traumata, 32 cases (20.8%) were affected with head trauma, 5 cases (3.2%) sustained spinal cord injury, and 3 cases (1.9%) suffered from thoracic trauma. Also, 47 cases (30.5%) were affected with VAP. Compared to the non-VAP group, the patients in VAP group had longer ICU stay (18.5±6.21 days vs. 9.21±2.91 days, P<0.001), longer intubation time (13.7±4.7 days vs. 6.06±2.05 days, P<0.001), longer mechanical ventilation time (12.9±5.1 days vs. 5.7±1.9 days, P<0.001), and more repeated intubations (1.2±0.50 vs. 1±0.0, P<0.001). There was no statistically significant difference between the two groups with respect to APACHE SCORE II (14.8±2.3 vs. 14.9±2.9). Additionally, there was no significant difference between the two groups regarding mortality rate (10.6 vs. 5.6, P=0.215).

Conclusions VAP caused longer ICU stay, increased intubation time, increased mechanical ventilation time, and more repeated intubations in traumatic in-patients, yet, it did not increase mortality rate in these patients. Patients with spinal cord and thoracic traumata are at risk for affliction with VAP.