Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation.

TLDR

The study aimed to identify risk factors for nosocomial pneumonia and fatality among ICU patients on continuous mechanical ventilation. A cohort of 233 ICU patients receiving continuous mechanical ventilation was examined for pneumonia incidence and associated variables. Ventilator‑associated pneumonia occurred in 21% of patients, with intracranial pressure monitoring, cimetidine use, fall‑winter admission, and 24‑hour ventilator circuit changes emerging as independent risk factors; 55% of those with pneumonia died, yet pneumonia was not an independent predictor of overall mortality.

Abstract

We studied risk factors for nosocomial pneumonia and fatality in 233 intensive care unit patients requiring continuous mechanical ventilation. Ventilator-associated pneumonia was diagnosed in 49 (21%) of the 233 patients. Of the 8 risk factors univariately associated with the development of pneumonia, only the presence of an intracranial pressure monitor (p less than 0.002), treatment with cimetidine (p less than 0.01), hospitalization during fall-winter seasons (p less than 0.04), and mechanical ventilator circuit changes every 24 h rather than every 48 h (p less than 0.02) remained significant after stepwise logistic regression. The overall fatality rate for the 49 patients who developed ventilator-associated pneumonia was 55%. Ventilator-associated pneumonia was 1 of 18 variables univariately associated with overall patient fatality, but it was not among the 7 variables present after multivariate analysis. The data delineate risk factors associated with the development of nosocomial pneumonia and fatality in patients receiving continuous mechanical ventilation.