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

Published online by Cambridge University Press:  27 August 2015

Shichao Zhu
Affiliation:
Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China
Lin Cai
Affiliation:
Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China
Chunhua Ma
Affiliation:
Department of Infection Control, Mianyang Central Hospital, Mianyang, China
Hongmei Zeng
Affiliation:
Department of Infection Control, The People’s Hospital of Dujiangyang City, Chengdu, China
Hua Guo
Affiliation:
Department of Infection Control, The Third People’s Hospital of Chengdu, Chengdu, China
Xiaoqing Mao
Affiliation:
Department of Infection Control, Nanchong Central Hospital, Nanchong, China
Chenghui Zeng
Affiliation:
Department of Infection Control, The Second People’s Hospital of Yibin City, Yibin, China
Xiaohong Li
Affiliation:
Department of Infection Control, The First People's Hospital of Neijing City, Neijiang, China
Hua Zhao
Affiliation:
Department of Infection Control, The People's Hospital of Deyang City, Deyang, China
Yongfang Liu
Affiliation:
Department of Infection Control, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
Shilian Liu
Affiliation:
Department of Infection Control, Dazhou Central Hospital, Dazhou, China
Juhua Sun
Affiliation:
Department of Infection Control, Bazhong Central Hospital, Bazhong
Ling Zhang
Affiliation:
Department of Infection Control, Chengdu Military General Hospital, Chengdu, China
Tingyong Peng
Affiliation:
Department of Infection Control, The People’s Hospital of Jiangyou City, Mianyang, China
Mina Dong
Affiliation:
Department of Infection Control, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
Liping Chen
Affiliation:
Department of Infection Control, The First People’s Hospital of Yibin City, Yibin, China
Zhiyong Zong*
Affiliation:
Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
*
Address all correspondence to Zhiyong Zong, Center of Infectious Diseases, West China Hospital (Huaxi), Guoxuexiang 37, Chengdu 610041, China (zongzhiy@scu.edu.cn).

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

Type
Original Articles
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

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).

References

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