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The Clinical Impact of Ventilator-Associated Events: A Prospective Multi-Center Surveillance Study

  • Shichao Zhu (a1), Lin Cai (a2), Chunhua Ma (a3), Hongmei Zeng (a4), Hua Guo (a5), Xiaoqing Mao (a6), Chenghui Zeng (a7), Xiaohong Li (a8), Hua Zhao (a9), Yongfang Liu (a10), Shilian Liu (a11), Juhua Sun (a12), Ling Zhang (a13), Tingyong Peng (a14), Mina Dong (a15), Liping Chen (a16) and Zhiyong Zong (a1) (a17)...

Abstract

OBJECTIVE

The Centers for Disease Control and Prevention (CDC) has developed an approach to ventilator-associated events (VAE) surveillance. Using these methods, this study was performed to investigate VAE incidences and to test whether VAEs are associated with poorer outcomes in China.

DESIGN

A 4-month, prospective multicenter surveillance study between April and July 2013.

SETTING

Our study included 15 adult intensive care units (ICUs) of 15 hospitals in China.

PATIENTS

Patients admitted to ICUs during the study period

METHODS

Patients on mechanical ventilation (MV) were monitored for VAEs: ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), and possible or probable ventilator-associated pneumonia (VAP). Patients with and without VACs were compared with regard to duration of MV, ICU length of stay (LOS), overall hospital LOS, and mortality rate.

RESULTS

During the study period, 2,356 of the 5,256 patients admitted to ICUs received MV for 8,438 ventilator days. Of these patients, 636 were on MV >2 days. VACs were identified in 94 cases (4.0%; 11.1 cases per 1,000 ventilator days), including 31 patients with IVACs and 16 with possible VAP but none with probable VAP. Compared with patients without VACs, patients with VACs had longer ICU LOS (by 6.2 days), longer duration on MV (by 7.7 days), and higher hospital mortality rate (50.0% vs 27.3%). The mortality rate attributable to VACs was 11.7%. Compared with those with VACs alone, patients with IVACs had longer duration on MV and increased ICU LOS but no higher mortality rates.

CONCLUSIONS

In China, surveillance of VACs and IVACs is able to identify MV patients with poorer outcomes. However, surveillance of possible and probable VAP can be problematic.

Infect. Control Hosp. Epidemiol. 2015;36(12):1388–1395

Copyright

Corresponding author

Address all correspondence to Zhiyong Zong, Center of Infectious Diseases, West China Hospital (Huaxi), Guoxuexiang 37, Chengdu 610041, China (zongzhiy@scu.edu.cn).

Footnotes

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PREVIOUS PRESENTATION. This work was presented at the 24th European Congress on Clinical Microbiology and Infection Diseases in Barcelona, Spain, May 10–13, 2014. as an oral presentation (No. 1093).

Footnotes

References

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