Crtical Care and Shock Journal

Ventilator Associated Pneumonia in Intensive Care Unit: Incidence, patient characteristics, outcome and validation of VAP-PIRO score in a local Chinese cohort

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Overview

Abstract

Objective: Despite a systematic scoring system has been developed to assess the severity and to stratify the mortality risk of Ventilator-Associated Pneumonia (VAP), few clinical studies had published in validating this scoring system. We intend to study the incidence of VAP in a local Chinese cohort and to validate the VAP-PIRO (Predisposition, Insult, Response, Organ Dysfunction) score.

Design: A prospective, observational cohort study.

Setting: A 20-bed mixed medical-surgical adult Intensive Care Unit (ICU) of a regional referral centre serving 650,000 populations.

Patients and participants: 269 consecutive patients who had been intubated and mechanically ventilated for more than 24 hours during an 8-month study period.

Interventions: None.

Measurements and results: VAP was diagnosed by National Healthcare Safety Network (NHSN) PNU1 criteria. Clinical characteristics, medical resource use and outcome of the cohort were studied. The VAP-PIRO score of each VAP case was calculated. The medical resource use and mortality in each PIRO risk group were compared. Of 269 patients admitted to ICU during the study period there were 59 VAP cases. The VAP incidence was 47.81 per 1,000 ventilator days. VAP-PIRO score was unable to stratify medical resource use and mortality in our cohort.

Conclusion: VAP-PIRO score cannot significantly differentiate mortality and usage of medical resources in our cohort. This is likely due to the severity of VAP in our cohort is modest when compared to the original cohort.

Arthur Ming-Chit Kwan, King-Chug Chan, Arthur Chun-Wing Lau, Wing-Wa Yan

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