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首页> 外文期刊>International Journal of Research in Medical Sciences >Incidence and risk factors associated with development of ventilator-associated pneumonia from a tertiary care center of northern India
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Incidence and risk factors associated with development of ventilator-associated pneumonia from a tertiary care center of northern India

机译：印度北部三级医疗中心与呼吸机相关性肺炎发展相关的发病率和危险因素

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Background: The incidence of VAP varies among different studies, depending on the definition, the type of hospital or ICU, the population studied, and the level of antibiotic exposure. This study was planned to ascertain and analyse the incidence and risk factors associated with development of ventilator-associated pneumonia from a tertiary care center. Methods: In this retrospective study, all the adult patients on mechanical ventilation (MV) for more than 48 hours in the Medicine Intensive Care Unit (MICU) and the Critical Care Unit (CCU) during September 2015 to February 2016 were included in the current study. Patients diagnosed with pneumonia prior to MV or within 48 hours of MV were excluded from the study. Patients' records served as study tools. Medical records department (MRD) was approached and data was collected on all patients who received mechanical ventilation during the study period. The relevant data were recorded from medical records, bedside flow sheets, radiographic reports, and reports of microbiological studies of the patients. The chi-square (χ2) test or Fisher's exact test was used to compare different groups. Univariate and multivariate logistic regression analysis was performed to identify risk factors associated with development of ventilator-associated pneumonia. Results: Overall incidence of VAP was 23.54 per 1,000 ventilator days. The incidence of VAP in MICU and CCU were 31.77 and 16.47 per 1,000 ventilator days respectively. 60% of the cases were late-onset VAP, while 40% were early-onset VAP. The most common organism isolated was Pseudomonas aeruginosa followed by Methicillin-resistant Staphylococcus aureus (MRSA). Impaired consciousness, tracheostomy, re-intubation, emergency intubation, and nasogastric tube were significantly associated with VAP. On multivariate analysis, impaired consciousness, emergency intubation and tracheostomy were independent risk factor for VAP among study subjects. Conclusions: Data thus generated can be used to plan and modulate the potential intervention measures while managing VAP. Knowledge of the important risk factors predisposing to VAP may prove to be useful in implementing effective preventive measures.
机译：背景：VAP的发生率在不同的研究中有所不同，这取决于定义，医院或ICU的类型，研究的人群以及抗生素的暴露水平。计划进行这项研究来确定和分析与三级护理中心的呼吸机相关性肺炎相关的发病率和危险因素。方法：在这项回顾性研究中，将2015年9月至2016年2月在药物重症监护室（MICU）和重症监护室（CCU）进行机械通气（MV）超过48小时的所有成年患者纳入当前研究范围。研究。在MV之前或MV 48小时内被诊断出患有肺炎的患者被排除在研究之外。患者记录用作研究工具。与医疗记录部门（MRD）取得了联系，并收集了研究期间所有接受机械通气的患者的数据。从医疗记录，床旁流程图，射线照相报告以及患者的微生物研究报告中记录相关数据。卡方（χ2）检验或Fisher精确检验用于比较不同组。进行单因素和多因素logistic回归分析，以确定与呼吸机相关性肺炎发生相关的危险因素。结果：VAP的总发生率为每1,000呼吸机天23.54。 MICU和CCU中VAP的发生率分别为每1000呼吸机天31.77和16.47。 60％的病例是迟发性VAP，而40％是早发性VAP。分离的最常见的生物是铜绿假单胞菌，其次是耐甲氧西林的金黄色葡萄球菌（MRSA）。意识障碍，气管切开，再次插管，紧急插管和鼻胃管与VAP显着相关。在多变量分析中，意识障碍，紧急​​插管和气管切开术是研究对象中VAP的独立危险因素。结论：由此产生的数据可用于在管理VAP的同时计划和调整潜在的干预措施。了解易患VAP的重要风险因素可能有助于实施有效的预防措施。

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