Journal Article

Risk Factors, Pathogens, and Outcomes of Ventilator-Associated Pneumonia in Non-Cardiac Surgical Patients: A Retrospective Analysis

Chang, Po-Hsun, Li, Wei-Feng, Chen, Ying-Ju, Lai, Wei-Hung, Liu, Yueh-Wei, Lin, Ting-Lung, Liu, Shih-Feng, Chang, Hui-Chuan, Lin, Yu-Cheng, Lin, Yu-Hung, Chen, I-Ling, Wang, Chih-Chi

2024

Overview

Ventilator-associated pneumonia (VAP) is a critical hospital-acquired infection following non-cardiac surgeries, leading to poor outcomes. This study identifies VAP risk factors in non-cardiac surgical patients and determines the causative pathogens. A retrospective analysis with 1:4 propensity-score matching was conducted on patients in a surgical intensive care unit (ICU) from 2010 to 2020 at a private tertiary medical center. Among 99 VAP patients, the mortality rate was 64.7%. VAP risk factors included prolonged mechanical ventilation (odds ratio [OR] 6.435; p < 0.001), repeat intubation (OR 6.438; p < 0.001), lower oxygenation levels upon ICU admission (OR 0.950; p < 0.001), and undergoing gastrointestinal surgery (OR 2.257; p = 0.021). The 30-day mortality risk factors in the VAP group were late-onset VAP (OR 3.450; p = 0.022), inappropriate antibiotic treatment (OR 4.083; p = 0.041), and undergoing gastrointestinal surgeries (OR 4.776; p = 0.019). Nearly half of the Gram-negative infections were resistant strains, and a third were polymicrobial infections. Non-cardiac surgical patients with VAP face adverse hospital outcomes. Identifying high-risk patients and understanding VAP’s resistant and microbial nature are crucial for appropriate treatment and improved health outcomes.

• Publisher: MDPI AG
• Subject: Abdomen / Antibiotics / Bacteria / Bacterial infections / Blood / cross infection / Gastrointestinal surgery / gastrointestinal system / Gram-negative bacteria / Health care facilities / Health risks / Health services / healthcare-associated pneumonia / Hospitals / Infections / Intensive care / Intubation / Leukocytes / Mechanical properties / Mechanical ventilation / Microorganisms / Mortality / Mortality risk / non-cardiac surgery / Nosocomial infections / odds ratio / Ostomy / Oxygenation / Pathogens / Patients / Pneumonia / Regression analysis / retrospective studies / risk / Risk analysis / Risk factors / Risk groups / Surgery / surgical critical illness / surgical intensive care unit / Ventilator-associated pneumonia / Ventilators