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Ventilator-associated pneumonia in trauma patients is associated with lower mortality : results from EU-VAP study

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Abstract
Background : Differences in trauma patients developing ventilator-associated pneumonia (VAP) are described regarding etiology and risk factors associated. We aim to describe the differences in outcomes in trauma and nontrauma patients with VAP. Methods : A prospective, observational study conducted in 27 intensive care units from nine European countries. We included patients requiring invasive mechanical ventilation for >48 hours who developed VAP. Logistic regression model was used to assess the factors independently associated with mortality in trauma patients with VAP. Results : A total of 2,436 patients were evaluated; 465 developed VAP and of these 128 (27.5%) were trauma patients. Trauma patients were younger than nontrauma (45.3 +/- 19.4 vs. 61.1 +/- 16.7, p < 0.0001). Nontrauma had higher simplified acute physiology score II compared with trauma patients (45.5 +/- 16.3 vs. 41.1 +/- 15.2, p = 0.009). Most prevalent pathogens in trauma patients with early VAP were Enterobacteriaceae spp. (46.9% vs. 27.8%, p = 0.06) followed by methicillin-susceptible Staphylococcus aureus (30.6% vs. 13%, p = 0.03) and then Haemophilus influenzae (14.3% vs. 1.9%, p = 0.02), and the most prevalent pathogen in late VAP was Acinetobacter baumannii (12.2% vs. 44.4%, p < 0.0001). Mortality was higher in nontrauma patients than in trauma patients (42.6% vs. 17.2%, p < 0.001, odds ratio [OR] = 3.55, 95% CI = 2.14-5.88). A logistic regression model adjusted for sex, age, severity of illness at intensive care unit admission, and sepsis-related organ failure assessment score at the day of VAP diagnosis confirmed that trauma was associated with a lower mortality compared with nontrauma patients (odds ratio [OR] = 0.37, 95% CI = 0.21-0.65)
Keywords
INTENSIVE-CARE-UNIT, Mortality, REQUIRING MECHANICAL VENTILATION, Etiology, RANDOMIZED-TRIAL, Ventilator-associated pneumonia, MANAGEMENT, GUIDELINES, DIAGNOSIS, OUTCOMES, MORBIDITY, ORGAN FAILURE, STRATEGIES, Trauma

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Chicago
Magret, M, R Amaya-Villar, J Garnacho, T Lisboa, E Diaz, Jan De Waele, M Deja, et al. 2010. “Ventilator-associated Pneumonia in Trauma Patients Is Associated with Lower Mortality : Results from EU-VAP Study.” Journal of Trauma-injury Infection and Critical Care 69 (4): 849–854.
APA
Magret, M., Amaya-Villar, R., Garnacho, J., Lisboa, T., Diaz, E., De Waele, J., Deja, M., et al. (2010). Ventilator-associated pneumonia in trauma patients is associated with lower mortality : results from EU-VAP study. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 69(4), 849–854.
Vancouver
1.
Magret M, Amaya-Villar R, Garnacho J, Lisboa T, Diaz E, De Waele J, et al. Ventilator-associated pneumonia in trauma patients is associated with lower mortality : results from EU-VAP study. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE. 2010;69(4):849–54.
MLA
Magret, M, R Amaya-Villar, J Garnacho, et al. “Ventilator-associated Pneumonia in Trauma Patients Is Associated with Lower Mortality : Results from EU-VAP Study.” JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE 69.4 (2010): 849–854. Print.
@article{1112725,
  abstract     = {Background : Differences in trauma patients developing ventilator-associated pneumonia (VAP) are described regarding etiology and risk factors associated. We aim to describe the differences in outcomes in trauma and nontrauma patients with VAP.
Methods : A prospective, observational study conducted in 27 intensive care units from nine European countries. We included patients requiring invasive mechanical ventilation for {\textrangle}48 hours who developed VAP. Logistic regression model was used to assess the factors independently associated with mortality in trauma patients with VAP.
Results : A total of 2,436 patients were evaluated; 465 developed VAP and of these 128 (27.5\%) were trauma patients. Trauma patients were younger than nontrauma (45.3 +/- 19.4 vs. 61.1 +/- 16.7, p {\textlangle} 0.0001). Nontrauma had higher simplified acute physiology score II compared with trauma patients (45.5 +/- 16.3 vs. 41.1 +/- 15.2, p = 0.009). Most prevalent pathogens in trauma patients with early VAP were Enterobacteriaceae spp. (46.9\% vs. 27.8\%, p = 0.06) followed by methicillin-susceptible Staphylococcus aureus (30.6\% vs. 13\%, p = 0.03) and then Haemophilus influenzae (14.3\% vs. 1.9\%, p = 0.02), and the most prevalent pathogen in late VAP was Acinetobacter baumannii (12.2\% vs. 44.4\%, p {\textlangle} 0.0001). Mortality was higher in nontrauma patients than in trauma patients (42.6\% vs. 17.2\%, p {\textlangle} 0.001, odds ratio [OR] = 3.55, 95\% CI = 2.14-5.88). A logistic regression model adjusted for sex, age, severity of illness at intensive care unit admission, and sepsis-related organ failure assessment score at the day of VAP diagnosis confirmed that trauma was associated with a lower mortality compared with nontrauma patients (odds ratio [OR] = 0.37, 95\% CI = 0.21-0.65)},
  author       = {Magret, M and Amaya-Villar, R and Garnacho, J and Lisboa, T and Diaz, E and De Waele, Jan and Deja, M and Manno, E and Rello, J and EU-VAP/CAP study group, the and Blot, Stijn},
  issn         = {0022-5282},
  journal      = {JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE},
  keyword      = {INTENSIVE-CARE-UNIT,Mortality,REQUIRING MECHANICAL VENTILATION,Etiology,RANDOMIZED-TRIAL,Ventilator-associated pneumonia,MANAGEMENT,GUIDELINES,DIAGNOSIS,OUTCOMES,MORBIDITY,ORGAN FAILURE,STRATEGIES,Trauma},
  language     = {eng},
  number       = {4},
  pages        = {849--854},
  title        = {Ventilator-associated pneumonia in trauma patients is associated with lower mortality : results from EU-VAP study},
  url          = {http://dx.doi.org/10.1097/TA.0b013e3181e4d7be},
  volume       = {69},
  year         = {2010},
}

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