Is a Low Incidence Rate of Ventilation Associated Pneumonia Associated with Lower Mortality? a Descriptive Longitudinal Study in Iran

BACKGROUND: Ventilator-Associated Pneumonia (VAP) is an important cause of morbidity and mortality in patients admitted to Intensive Care Unit (ICU). The current study conducted to estimate VAP incidence, attributable mortality and case fatality rate, cost, so related factors can affect the outcome in patients. MATERIALS AND METHODS: In this descriptive longitudinal study, demographic, clinical and para-clinical data were collected and attributable mortality and case fatality rate was estimated. Multivariable analysis was done to predict the possible risk factors on the outcome of VAP patients. Also, patients’ survival curve was plotted based on their length of ICU stay. Finally, the additional cost due to VAP in ICU was estimated. RESULTS: Totally, 8% ICU admissions were affected by VAP and 4% expired during the ICU stay. Further, the attributable mortality rate of VAP was high as compared with standard mortality rate. The most case fatality rate was for Acinetobacter sp. (n=17 60.7%). In multivariable logistic regression analysis, age greater than 40 years, more than 96 hours mechanical ventilation and uncontrolled diabetes mellitus were predictor factors of higher mortality. Inverse association between survival time and ICU length of stay was reported. Finally, the additional cost of VAP was estimated of about 700 US$ per patients. CONCLUSION: According to the results, strategies to prevent mortality by reducing the duration of ventilation and ICU length of stay should be performed. Also, mandatory fees for the family and the healthcare system should be planned.