Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia
Objectives. To determine risk factors associated with ventilator dependence in patients with ventilator-associated pneumonia (VAP). Study Design. A retrospective study was conducted at Chang Gung Memorial Hospital, Kaohsiung, from January 1, 2007 to January 31, 2008. Methods. This study evaluated 16...
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| Format: | Article |
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Wiley
2012-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1100/2012/547241 |
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| author | Chia-Cheng Tseng Kuo-Tung Huang Yung-Che Chen Chin-Chou Wang Shih-Feng Liu Mei-Lien Tu Yu-Hsiu Chung Wen-Feng Fang Meng-Chih Lin |
| author_facet | Chia-Cheng Tseng Kuo-Tung Huang Yung-Che Chen Chin-Chou Wang Shih-Feng Liu Mei-Lien Tu Yu-Hsiu Chung Wen-Feng Fang Meng-Chih Lin |
| author_sort | Chia-Cheng Tseng |
| collection | DOAJ |
| description | Objectives. To determine risk factors associated with ventilator dependence in patients with ventilator-associated pneumonia (VAP). Study Design. A retrospective study was conducted at Chang Gung Memorial Hospital, Kaohsiung, from January 1, 2007 to January 31, 2008. Methods. This study evaluated 163 adult patients (aged ≥18 years). Eligibility was evaluated according to the criterion for VAP, Sequential Organ Failure Assessment (SOFA) score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II) score. Oxygenation index, underlying comorbidities, septic shock status, previous tracheostomy status, and factors related to pneumonia were collected for analysis. Results. Of the 163 VAP patients in the study, 90 patients survived, yielding a mortality rate of 44.8%. Among the 90 surviving patients, only 36 (40%) had been weaned off ventilators at the time of discharge. Multivariate logistic regression analysis was used to identify underlying factors such as congestive cardiac failure (P=0.009), initial high oxygenation index value (P=0.04), increased SOFA scores (P=0.01), and increased APACHE II scores (P=0.02) as independent predictors of ventilator dependence. Results from the Kaplan-Meier method indicate that initial therapy with antibiotics could increase the ventilator weaning rate (log Rank test, P<0.001). Conclusions. Preexisting cardiopulmonary function, high APACHE II and SOFA scores, and high oxygenation index were the strongest predictors of ventilator dependence. Initial empiric antibiotic treatment can improve ventilator weaning rates at the time of discharge. |
| format | Article |
| id | doaj-art-517a665fc84e49a789b4ba459d517f0d |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-517a665fc84e49a789b4ba459d517f0d2025-02-03T01:31:03ZengWileyThe Scientific World Journal1537-744X2012-01-01201210.1100/2012/547241547241Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated PneumoniaChia-Cheng Tseng0Kuo-Tung Huang1Yung-Che Chen2Chin-Chou Wang3Shih-Feng Liu4Mei-Lien Tu5Yu-Hsiu Chung6Wen-Feng Fang7Meng-Chih Lin8Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 813, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, TaiwanObjectives. To determine risk factors associated with ventilator dependence in patients with ventilator-associated pneumonia (VAP). Study Design. A retrospective study was conducted at Chang Gung Memorial Hospital, Kaohsiung, from January 1, 2007 to January 31, 2008. Methods. This study evaluated 163 adult patients (aged ≥18 years). Eligibility was evaluated according to the criterion for VAP, Sequential Organ Failure Assessment (SOFA) score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II) score. Oxygenation index, underlying comorbidities, septic shock status, previous tracheostomy status, and factors related to pneumonia were collected for analysis. Results. Of the 163 VAP patients in the study, 90 patients survived, yielding a mortality rate of 44.8%. Among the 90 surviving patients, only 36 (40%) had been weaned off ventilators at the time of discharge. Multivariate logistic regression analysis was used to identify underlying factors such as congestive cardiac failure (P=0.009), initial high oxygenation index value (P=0.04), increased SOFA scores (P=0.01), and increased APACHE II scores (P=0.02) as independent predictors of ventilator dependence. Results from the Kaplan-Meier method indicate that initial therapy with antibiotics could increase the ventilator weaning rate (log Rank test, P<0.001). Conclusions. Preexisting cardiopulmonary function, high APACHE II and SOFA scores, and high oxygenation index were the strongest predictors of ventilator dependence. Initial empiric antibiotic treatment can improve ventilator weaning rates at the time of discharge.http://dx.doi.org/10.1100/2012/547241 |
| spellingShingle | Chia-Cheng Tseng Kuo-Tung Huang Yung-Che Chen Chin-Chou Wang Shih-Feng Liu Mei-Lien Tu Yu-Hsiu Chung Wen-Feng Fang Meng-Chih Lin Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia The Scientific World Journal |
| title | Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia |
| title_full | Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia |
| title_fullStr | Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia |
| title_full_unstemmed | Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia |
| title_short | Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia |
| title_sort | factors predicting ventilator dependence in patients with ventilator associated pneumonia |
| url | http://dx.doi.org/10.1100/2012/547241 |
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