Attributable mortality of ventilator-associated pneumonia: a meta-analysis
Abstract number: O507
Agrafiotis M., Siempos I., Ntaidou T., Falagas M.
Objective: To investigate whether ventilator-associated pneumonia (VAP) is a true cause of mortality in the intensive care unit (ICU) setting.
Methods: We performed a meta-analysis of available data obtained through search of PubMed and relevant bibliographies without time restrictions. A conservative DerSimonian-Laird random effects model was employed to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs).
Results: Out of 968 retrieved reports, 44 papers fulfilled our inclusion criteria. Presence, as opposed to absence, of VAP was associated with higher mortality in the ICU setting (OR: 1.96, 95% CI: [1.26, 3.04]). This result persisted when matched case control studies (OR 1.73, 95% CI: [1.23, 2.45]) or studies in which VAP was microbiologically confirmed in all patients (OR: 2.20, 95% CI: [1.01, 4.81]) were evaluated separately. VAP was still associated with higher mortality when the impact of immunosuppresion was controlled (OR: 1.74, 95% CI: [0.95, 3.16]); a finding that did not reach statistical significance. Though, presence of VAP was not associated with higher mortality in the subgroup analysis of studies including patients who received appropriate initial antimicrobial treatment (OR 1.64 [0.68, 3.96]).
Conclusion: Presence, compared to absence, of VAP seems to be associated with higher mortality in critically ill patients. Appropriateness of initial antimicrobial treatment in such patients may moderate this association.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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