Factors Predictive of Ventilator-associated Pneumonia in Critically Ill Trauma Patients

Background Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation. We sought to investigate factors associated with the development of VAP in critically ill trauma patients. Methods We conducted a retrospective review of trauma patients admitted to our trauma inten...

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Bibliographic Details
Published in:World journal of surgery 2020-04, Vol.44 (4), p.1121-1125
Main Authors: Younan, Duraid, Delozier, Sarah J., Adamski, John, Loudon, Andrew, Violette, Aisha, Ustin, Jeffrey, Tinkoff, Glen, Moorman, Matthew L., McQuay, Nathaniel
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Cardiac Surgery
Critical Illness
Demographics
Demography
Female
General Surgery
Humans
Incidence
Injuries
Injury Severity Score
Intensive care
Intensive Care Units
Kidneys
Male
Mechanical ventilation
Medicine
Medicine & Public Health
Middle Aged
Original Scientific Report
Pneumonia
Pneumonia, Ventilator-Associated - epidemiology
Pneumonia, Ventilator-Associated - etiology
Regression analysis
Regression models
Retrospective Studies
Spine
Sternum
Surgery
Thoracic Surgery
Transfusion
Trauma
Vascular Surgery
Ventilation
Ventilator-associated pneumonia
Ventilators
Wounds and Injuries - surgery
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Summary:Background Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation. We sought to investigate factors associated with the development of VAP in critically ill trauma patients. Methods We conducted a retrospective review of trauma patients admitted to our trauma intensive care unit between 2016 and 2018. Patients with ventilator-associated pneumonia were identified from the trauma database. Data collected from the trauma database included demographics (age, gender and race), mechanism of injury (blunt, penetrating), injury severity (injury severity score “ISS”), the presence of VAP, transfused blood products and presenting vital signs. Results A total of 1403 patients were admitted to the trauma intensive care unit (TICU) during the study period; of these, 45 had ventilator-associated pneumonia. Patients with VAP were older ( p  = 0.030), and they had a higher incidence of massive transfusion ( p  = 0.015) and received more packed cells in the first 24 h of admission ( p  = 0.028). They had a higher incidence of face injury ( p  = 0.001), injury to sternum ( p  = 0.011) and injury to spine ( p  = 0.024). Patients with VAP also had a higher incidence of acute kidney injury (AKI) ( p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-019-05286-3