Assessment of Early- and Late-Onset Ventilator-Associated-Pneumonia in Patients Admitted for Neurosurgical Procedures

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Ventilator-associated pneumonia (VAP) is among the most common etiologies of mortality in intensive care unit (ICU). Studies about VAP among patients under mechanical ventilation admitted for neurosurgery procedures are limited while probability of VAP among these patients is high, because of oropharyngeal aspiration following brain injury. In the current study, the etiology of early- and late-onset VAP was assessed among the patients admitted for neurosurgical procedures.Methods: Current cross-sectional study was conducted on 82 patients with VAP following neurosurgical procedure. Information about patients including demographics, early/late-onset VAP, the score of Acute Physiology and Chronic Health Evaluation II (APACHE II), Clinical Pulmonary Infection Score (CPIS), underlying reason of neurosurgical procedure, medical history, smoking history, and smear/culture, and antibiograms were recorded and analyzed.Findings: VAP type was not in association with age (P = 0.560), gender (P = 0.270), etiology of neurosurgery (P = 0.960), and medical history (P = 0.930), but was statistically in association with admission duration (P = 0.034), smoking (P < 0.001), APACHE II score (P < 0.001), and CPIS score (P < 0.001). Duration of admission [odds ratio (OR) = 4.71; confidence interval of 95% (95%CI): 1.04-21.35; P = 0.040) and smoking (OR = 1.07; 95%CI: 1.01-1.14; P = 0.015) were independently in association with VAP. There was no association between type of VAP and Gram staining (P = 0.330) and antibiogram (P = 0.140).Conclusion: Based on the current study, duration of admission, mortality, smoking, APACHE II score, and CPIS score were significantly higher among late-onset VAP. Moreover, admission duration and smoking was independently in association with VAP regardless of its type. The microbial pattern was not in association with late/early-onset VAP.

Keywords

References

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Journal of Isfahan Medical School
Volume 37, Issue 515 - Serial Number 515
January and February 2019
Pages 73-79

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History

  • Receive Date: 13 October 2018
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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