by Olivier Pouly, Sylvain Lecailtel, Sophie Six, Sébastien
Préau, Frédéric Wallet, Saad Nseir and Anahita Rouzé
Background
The aim of this study was to investigate the concordance
between ventilator-associated events (VAE) and ventilator-associated lower
respiratory tract infections (VA-LRTI), and their impact on outcome.
Methods
This retrospective study was performed in five 10-bed ICUs
of a teaching hospital, during a 2-year period. Ventilator-associated lower
respiratory tract infections (VA-LRTI), including ventilator-associated
tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP) were
prospectively diagnosed. The agreement between VAE, VAT and VAP was assessed by
k statistics.
Results
A total of 1059 patients (15,029 ventilator-days) were
included. 268 VAP (17.8 per 1000 ventilator-days), 127 VAT (8.5 per 1000
ventilator-days) and 262 VAE (17.4 per 1000 ventilator-days) were diagnosed.
There was no agreement between VAT and VAE, and the agreement was poor between
VAP and VAE (k = 0.12, 95% CI 0.03–0.20). VAE and VA-LRTI were associated with
significantly longer duration of mechanical ventilation, ICU and hospital
length of stay. VAP, VAT and VAE were not significantly associated with mortality
in multivariate analysis.
Conclusions
The agreement was poor between VAE and VAP. No agreement was
found between VAE and VAT. VAE episodes were significantly associated with
longer duration of mechanical ventilation and length of stay, but not with ICU
mortality.
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