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Epidemiology and Burden of Ventilator-Associated Pneumonia among adult intensive care unit patients: A portuguese, multicenter, retrospective study (eVAP-PT Study)

2024-03-22Journal article Open access
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dc.contributor.authorMergulhão, Paulo
dc.contributor.authorPereira, João Gonçalves
dc.contributor.authorFernandes, Antero Vale
dc.contributor.authorKrystopchuk, Andriy
dc.contributor.authorRibeiro, João Miguel
dc.contributor.authorMiranda, Daniel
dc.contributor.authorCastro, Heloísa
dc.contributor.authorEira, Carla
dc.contributor.authorMorais, Juvenal
dc.contributor.authorLameirão, Cristina
dc.contributor.authorGomes, Sara
dc.contributor.authorLeal, Dina
dc.contributor.authorDuarte, Joana
dc.contributor.authorPássaro, Leonor
dc.contributor.authorFroes, Filipe
dc.contributor.authorMartin-Loeches, Ignacio
dc.date.accessioned2024-12-11T11:15:44Z
dc.date.available2024-12-11T11:15:44Z
dc.date.issued2024-03-22
dc.description.abstractVentilator-associated pneumonia (VAP) is a prevailing nosocomial infection in critically ill patients requiring invasive mechanical ventilation (iMV). The impact of VAP is profound, adversely affecting patient outcomes and placing a significant burden on healthcare resources. This study assessed for the first time the contemporary VAP epidemiology in Portugal and its burden on the healthcare system and clinical outcomes. Additionally, resource consumption (duration of iMV, intensive care unit (ICU), hospital length of stay (LOS)) and empirical antimicrobial therapy were also evaluated. This multicenter, retrospective study included patients admitted to the hospital between July 2016 and December 2017 in a participating ICU, who underwent iMV for at least 48 h. Patients with a VAP diagnosis were segregated for further analysis (n = 197). Control patients, ventilated for >48 h but without a VAP diagnosis, were also included in a 1:1 ratio. Cumulative VAP incidence was computed. All-cause mortality was assessed at 28, 90, and 365 days after ICU admission. Cumulative VAP incidence was 9.2% (95% CI 8.0-10.5). The all-cause mortality rate in VAP patients was 24.9%, 34.0%, and 40.6%, respectively, and these values were similar to those observed in patients without VAP diagnosis. Further, patients with VAP had significantly longer ICU (27.5 vs. 11.0 days, p < 0.001) and hospital LOS (61 vs. 35.9 days, p < 0.001), more time under iMV (20.7 vs. 8.0 days, p < 0.001) and were more often subjected to tracheostomy (36.5 vs. 14.2%; p < 0.001). Patients with VAP who received inappropriate empirical antimicrobials had higher 28-day mortality, 34.3% vs. 19.5% (odds ratio 2.16, 95% CI 1.10-4.23), although the same was not independently associated with 1-year all-cause mortality (p = 0.107). This study described the VAP impact and burden on the Portuguese healthcare system, with approximately 9% of patients undergoing iMV for >48 h developing VAP, leading to increased resource consumption (longer ICU and hospital LOS). An unexpectedly high incidence of inappropriate, empirical antimicrobial therapy was also noted, being positively associated with a higher mortality risk of these patients. Knowledge of the Portuguese epidemiology characterization of VAP and its multidimensional impact is essential for efficient treatment and optimized long-term health outcomes of these patients.eng
dc.identifier.doi10.3390/antibiotics13040290
dc.identifier.issn2079-6382
dc.identifier.urihttp://hdl.handle.net/10400.1/26448
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.hasversionhttps://www.mdpi.com/2079-6382/13/4/290
dc.relation.ispartofAntibiotics
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectVAP (ventilator-associated pneumonia)
dc.subjectHospital stay
dc.subjectInvasive mechanical ventilation
dc.subjectNosocomial infections
dc.subjectSepsis
dc.titleEpidemiology and Burden of Ventilator-Associated Pneumonia among adult intensive care unit patients: A portuguese, multicenter, retrospective study (eVAP-PT Study)eng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage11
oaire.citation.issue4
oaire.citation.startPage1
oaire.citation.titleAntibiotics
oaire.citation.volume13
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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