Retrospective Analysis of the Risk Factors and Pathogens Associated With Early-onset Ventilator-associated Pneumonia in Surgical-ICU Head-trauma Patients

2010 ◽  
Vol 22 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Didier Lepelletier ◽  
Antoine Roquilly ◽  
Dominique Demeure dit latte ◽  
Pierre Joachim Mahe ◽  
Olivier Loutrel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Analysis ◽  
Head Trauma ◽  
Early Onset ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Surgical Icu

Early Onset Pneumonia

2004 ◽  
Vol 100 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Régis Bronchard ◽  
Pierre Albaladejo ◽  
Gilles Brezac ◽  
Arnaud Geffroy ◽  
Pierre-François Seince ◽  
...  
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Head Trauma ◽  
Early Onset ◽  
Odds Ratio ◽  
Nasal Carriage ◽  
Arterial Oxygen ◽  
Surgical Intensive Care Unit ◽  
Trauma Patients ◽  
Independent Risk Factors

Background Early onset pneumonia occurs frequently in head trauma patients, but the potential consequences and the risk factors of this event have been poorly studied. Methods This prospective observational study was undertaken in the surgical intensive care unit of a university teaching hospital in Clichy, France. Head trauma patients requiring tracheal intubation for neurologic reasons and ventilation for at least 2 days were studied to assess the risk factors and the consequences of early onset pneumonia. Results During a 2-yr period, 109 head trauma patients were studied. The authors found an incidence of early onset pneumonia of 41.3%. Staphylococcus aureus was the most common bacteria involved in early onset pneumonia. Patients with early onset pneumonia had a lower worst arterial oxygen tension:fraction of inspired oxygen ratio, more fever, more arterial hypotension, and more intracranial hypertension, factors known to worsen the neurologic prognosis of head trauma patients. Nasal carriage of S. aureus on admission (odds ratio, 5.1; 95% confidence interval, 1.9-14.0), aspiration before intubation (odds ratio, 5.5; 95% confidence interval, 1.9-16.4) and barbiturate use (odds ratio, 3.9; 95% confidence interval, 1.2-12.8) were found to be independent risk factors of early onset pneumonia. Conclusions The results suggest that early onset pneumonia leads to secondary injuries in head-injured patients. Nasal carriage of S. aureus, aspiration before intubation, and use of barbiturates are specific independent risk factors for early onset pneumonia and must be assessed to find and evaluate strategies to prevent early onset pneumonia.

Tracheal colonisation within 24 h of intubation in patients with head trauma: risk factor for developing early-onset ventilator-associated pneumonia

2000 ◽  
Vol 26 (9) ◽  
pp. 1369-1372 ◽  
Author(s):  
J.M. Sirvent ◽  
A. Torres ◽  
L. Vidaur ◽  
J. Armengol ◽  
J. de Batlle ◽  
...  
Keyword(s):  
Risk Factor ◽  
Head Trauma ◽  
Early Onset ◽  
Ventilator Associated Pneumonia

Hazard Ratio of 90-Day Mortality in ICU Patients with Abdominal Injuries Compared with Head Injuries

2021 ◽  
Vol 24 (12) ◽  
pp. 897-902
Author(s):  
Farshid Rahimi-Bashar ◽  
Sara Ashtari ◽  
Ali Fathi Jouzdani ◽  
Seyed Jalal Madani ◽  
Keivan Gohari-Moghadam
Keyword(s):  
Head Trauma ◽  
Abdominal Trauma ◽  
Head Injuries ◽  
Public Health Problem ◽  
Hazard Ratio ◽  
Major Public Health Problem ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
Icu Patients ◽  
Surgical Icu

Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077–7.063, P=0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85±20.1, 30.27±18.22 and 31.43±26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.

Risk Factors for Ventilator-associated Pneumonia by Pseudomonas aeruginosa  in Presence of Recent Antibiotic Exposure

2006 ◽  
Vol 105 (4) ◽  
pp. 709-714 ◽  
Author(s):  
Jordi Rello ◽  
Camilla Allegri ◽  
Alejandro Rodriguez ◽  
Loreto Vidaur ◽  
Gonzalo Sirgo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Relative Risk ◽  
Confidence Interval ◽  
Early Onset ◽  
Late Onset ◽  
Interquartile Range ◽  
Ventilator Associated Pneumonia ◽  
Antibiotic Exposure ◽  
Retrospective Case

Background To facilitate the decision-making process for therapy and prevention of ventilator-associated pneumonia (VAP) in patients undergoing recent antibiotic exposure, this study investigated whether the development of VAP episodes caused by Pseudomonas aeruginosa or other pathogens are related to different risk factors, thereby distinguishing two risk population for this serious complication. Methods A 5-year retrospective case-control observational study was conducted. Cases of VAP caused by P. aeruginosa were compared with those caused by other pathogens. Univariate and multivariate analysis was performed using SPSS 11.0 software (SPSS Inc., Chicago, IL). Results Two groups were identified: P. aeruginosa (group P) was isolated in 58 (63.7%) episodes, and 33 episodes served as controls (group C), after a median of 12 days (interquartile range, 4-28 days) and 9 days (interquartile range, 3-12.5 days) of mechanical ventilation, respectively. P. aeruginosa was identified in 34.7% of episodes with early-onset pneumonia and in 73.5% with late-onset pneumonia. In a logistic regression analysis, P. aeruginosa was independently associated with duration of stay of 5 days or longer (relative risk = 3.59; 95% confidence interval, 1.04-12.35) and absence of coma (relative risk = 8.36; 95% confidence interval, 2.68-26.09). Risk for pathogens different from P. aeruginosa (group C) in early-onset pneumonia associated with coma was estimated to be 87.5%. Conclusions Risk factors in episodes under recent antibiotic treatment caused by P. aeruginosa or other microorganism are not the same, a fact that could have implications for preventive and therapeutic approaches for this infection.

scholarly journals Risk factors for ventilator-associated pneumonia in trauma patients: A descriptive analysis

2018 ◽  
Vol 9 (3) ◽  
pp. 203 ◽  
Author(s):  
Suresh Kumar Arumugam ◽  
Insolvisagan Mudali ◽  
Gustav Strandvik ◽  
Ayman El-Menyar ◽  
Ammar Al-Hassani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Descriptive Analysis ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia

Su1728 - Risk Factors for Early Onset Colorectal Cancer: A Retrospective Analysis

2018 ◽  
Vol 154 (6) ◽  
pp. S-568-S-569
Author(s):  
Valerie Gausman ◽  
David Dornblaser ◽  
Sanya Anand ◽  
Kelli O'Connell ◽  
Mengmeng Du ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Retrospective Analysis ◽  
Early Onset ◽  
Early Onset Colorectal Cancer

scholarly journals Timelines of Oral Care and Early-Onset Ventilator Associated Pneumonia Prevention

2014 ◽  
Author(s):  
Kristen Francoeur
Keyword(s):  
Endotracheal Tube ◽  
Early Onset ◽  
Local Level ◽  
Quality Care ◽  
Oral Care ◽  
Retrospective Chart Review ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Prevention Measures ◽  
Early Application

<p>Hospital-acquired infections, including ventilator associated pneumonia (VAP), are a significant cause of morbidity and mortality and associated with increased costs and length of stay (Chastre & Fagon, 2002; NNIS, 2004). Ventilator associated pneumonia is believed to primarily result from aspiration of oropharyngeal secretions around the endotracheal tube cuff into the lungs (Grap, Munro, Unoki, Hamilton, & Ward, 2012). A randomized control trial tested early application of oral chlorhexidine (CHG) on oral microbial flora and VAP in trauma patients and suggested that early (within 12 hours of intubation) application may reduce VAP rates in trauma patients (Grap, Munro, Hamilton, Elswick, Sessler & Ward, 2011). The VAP rate in a local Level 1 trauma center, 11-bed trauma intensive care unit (TICU) was 8.7 per 1000 device days, above the national average (NHSN, 2011). The purpose of this research was to explore the relationship between the time of insertion of an endotracheal tube and first CHG application and early onset (within 72 hours of intubation) VAP. A retrospective chart review of the records of randomly selected adult intubated trauma patients hospitalized on the TICU was conducted. Collected data included: time of intubation; timing of CHG application; VAP occurrences; and length of intubation. Less than half (45.8%) of patients received early CHG application, and most (79.2%) were intubated in the emergency department (ED), suggesting that VAP prevention measures begin in the ED. Of the patients reviewed, five developed VAP; three occurred in patients who had received oral CHG within 12 hours of intubation. A CNS-driven collaboration with other disciplines and departments is essential to implement VAP prevention measures and provide comprehensive, quality care.</p>

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