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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2017 Dec 13

DOI: 10.23736/S0375-9393.17.12198-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

An Observational Veneto research on Ventilator Associated Pneumonia (OVeRVAP): attributable mortality and cumulative incidence of ventilator-associated pneumonia

Armando OLIVIERI 1 , Daniele DEL MONTE 2, Luca BENACCHIO 1, Daniele BONVICINI 2, Marco BAIOCCHI 3, Camilla ALLEGRI 4, Luana FORNASIER 5, Alessandra CARLOT 6, Ioannis PSIMADAS 6, Alfeo BONATO 2, Mara BERNASCONI 7, Andrea MEDÈ 8, Andrea BIANCHIN 8, Mario PETA 9, Massimiliano CARAVELLO 10, Roberta RAMPAZZO 11, Antonella PEDRINI 11, Massimiliano DALSASSO 12, Debora SAGGIORO 13, Andrea ZENNARO 14, Carlo ORI 12, Ernesto PIZZIRANI 2

1 Epidemiology Unit, Local Health Unit 15, Veneto Region, Padova, Italy; 2 Intensive Care Unit, Local Health Unit 15, Veneto Region, Padova, Italy; 3 Intensive Care Unit, Local Health Unit 3, Veneto Region, Padova, Italy; 4 Neurointensive Care Unit, Verona University Hospital, Verona, Italy; 5 Intensive Care Unit, Local Health Unit 6, Veneto Region, Vicenza, Italy; 6 Intensive Care Unit, Local Health Unit 13, Veneto Region, Spinea, Venezia, Italy; 7 Intensive Care Unit, Local Health Unit 18, Veneto Region, Rovigo, Italy; 8 Intensive Care Unit, Local Health Unit 8, Veneto Region, Asolo, Treviso Italy; 9 Intensive Care Unit, Local Health Unit 9, Veneto Region, Treviso, Italy; 10 Department of Anesthesia and Intensive Care, Padova University Hospital, Padova, Italy; 11 Clinical Research Unit, Local Health Unit 15, Veneto Region, Padova, Italy; 12 Department of Anesthesia and Intensive Care, Padova University Hospital, Padova, Italy; 13 Intensive Care Unit, Local Health Unit 12, Veneto Region, Venezia, Italy; 14 Intensive Care Unit, Local Health Unit 19, Veneto Region, Adria, Italy


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BACKGROUND: The association between Ventilator-associated pneumonia (VAP) and mortality varies from study to study, and its entity is uncertain due a considerable variation in the attributable mortality. The aim of this study was to evaluate the relationship between VAP frequency and mortality in a cohort of mechanically ventilated patients.
METHODS: A multicentre prospective observational study was conducted in 21 Intensive Care Units (ICU). The patients were recruited from 2008 to 2010 within randomly selected periods. 842 patients of 2595 admitted, met the eligibility criteria and were enrolled in the study. The study’s primary outcome was death by any cause in one of the ICUs. We modelled VAP occurrence as a time-dependent covariate and fitted a competing risk analysis model. We estimated the attributable mortality of VAP as the population- attributable fraction of ICU mortality.
RESULTS: 121 patients developed VAP (14.4%), for an incidence rate of 15.7 cases per 1000 ventilator- days. 175 patients died during the study period (20.8%), 31 of these had VAP (25.6%). The ICU mortality rate in the patients who developed VAP was 22.6 per 1000 ventilator-days (95% C.I., 15.9 - 32.1). We estimated an attributable mortality of 8.4%.
CONCLUSIONS: In 8.4% of cases, VAP was the leading cause of death in our study. This indicates that the patients died more frequently with VAP rather than because of it.


KEY WORDS: Ventilator-associated Pneumonia - Attributable mortality - Competing risks

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Publication History

Article first published online: December 13, 2017
Manuscript accepted: November 30, 2017
Manuscript revised: October 12, 2017
Manuscript received: May 25, 2017

Per citare questo articolo

Olivieri A, Del Monte D, Benacchio L, Bonvicini D, Baiocchi M, Allegri C et al. An observational veneto research on ventilator associated pneumonia (OVeRVAP): attributable mortality and cumulative incidence of ventilator-associated pneumonia. Minerva Anestesiol 2017 Dec 13. DOI: 10.23736/S0375-9393.17.12198-X

Corresponding author e-mail

armando.olivieri@aulss6.veneto.it