Risk factor analysis on ventilator associated pneumonia among multiple injury patients with mechanical ventilation in comprehensive ICU

Abstract

Objective To explore the risk factors of VAP among multiple injury patients in comprehensive ICU so as to provide the basis for prevention and cure of VAP. Methods The retrospective analysis was made to the clinical data from 126 patients with mechanical ventilation for over 48 hours in ICU at the Third People's Hospital of Zhenjiang, the Affiliated Hospital of Jiangsu University, from January 2014 to December 2015. The Logistic regression analysis was performed to research related data in order to identify the risk factors of VAP. Results In 126 patients, there were 37 (29.37%) patients with VAP. Single factor analysis showed that the risk factors were the time of mechanical ventilation, score of the injury severity scale (ISS) , time of being admitted to ICU, coma, sedation and analgesia, hormone use, medical history of chronic lung disease, combined antibiotic (>2 kinds) , craniocerebral trauma, thoracic injury, spinal injury with significant differences (t/χ2=3.382, 20.241, 4.212, 29.837, 7.616, 5.322, 4.384, 8.246, 5.677, 15.394, 4.864; P 2 kinds) , medical history of chronic lung disease, craniocerebral trauma, thoracic injury (OR=3.897, 6.697, 5.506, 5.104, 10.984, 4.911, 6.046; P<0.05) . Conclusions The incidence of VAP is high among multiple injury patients in comprehensive ICU. The monitor of risk factors of VAP in multiple injury patients should be enhanced. Moreover, the effective intervention on prevention and cure of VAP should be taken for patients with long time of mechanical ventilation, high score of ISS, coma, combined antibiotic (>2 kinds) , medical history of chronic lung disease, craniocerebral trauma, thoracic injury and so on so as to reduce the incidence of VAP. Key words: Intensive care units; Pneumonia, ventilator-associated; Multiple injury; Risk factors