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Background <p>Ventilator-associated infectious complications are the most prevalent healthcare-acquired infection in intensive care units. The surveillance of ventilator-associated events (VAE) has now supplanted traditional ventilator-associated pneumonia (VAP) monitoring. However, its use is not common and limited reports have been published. We aimed to describe the epidemiology, etiology and the prognosis of VAE.</p> Methods <p>This multicenter observational-descriptive study was conducted at 15 centers with active prospective surveillance of VAE. Their daily basis follow-up was for 90&#xa0;days. The Centers for Disease Control and Prevention guideline 2015 update was used for the definition of VAE. VAE subdiagnosis was defined as ventilator-associated condition (VAC), infection-related ventilator-associated complication plus (IVAC-plus), infection-related ventilator-associated complications (IVAC), and possible ventilator-associated pneumonia (PVAP)</p> Results <p>A total of 185 VAE episodes developed in 174 of the 1018 patients included in the study. The VAE incidences per 1000 mechanical ventilation day were; VAC 2.33, IVAC-plus 6.0, IVAC 1.3 and PVAP 4.7. Additionally 158 VAP episodes (14.8%, 7.09/1000 MV days) were observed, 85 (45.9%, 4.99/1000 MV days) of them fit the definition of a concurrent VAE criteria.</p> <p>Risk factors for VAE included a Sequential Organ Failure Assessment (SOFA) score greater than 7 on admission (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.23–2.47), the presence of a tracheostomy (OR:1.78; CI:1.19-2.65), and antibiotic use within the previous 90 days (OR:2.41; CI:1.09-4.20) were risk factors for VAE.</p> <p>The mortality rate was 59.6% in ventilated patients. Multivariate analysis identified several risk factors for mortality, as follows: age greater than 63 years (OR: 1.75; CI: 1.26–2.42), a SOFA score greater than 5 on admission (OR: 2.00; CI: 1.47–1.46), a higher mean Charlson Comorbidity Index (OR: 1.08; CI: 1.02–1.13), being a medical-type patient (OR: 1.54; CI: 1.06–2.21), healthcare-associated infections (OR: 2.01; CI: 1.39–2.88), and the occurrence of VAE (OR: 2.21; CI: 1.04–4.70).</p> Conclusion <p>VAE is a common complication in intubated patients and is 2.21 times more likely to occur in intubated patients who die. Patients with a high SOFA score, tracheostomy and antibiotic use in the last 90 days are at increased risk. prevention of VAE in intubated patients is important for patient survival.</p>

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Epidemiology of ventilator associated events in intubated patients: a multicenter observational study

  • 期刊论文

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  • 发表日期：

    2025年10月21日

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  • Esma Eryılmaz Eren,
  • Duygu Mert,
  • Fatma Eser,
  • Seniha Senbayrak,
  • Gamze Kalın,
  • Gulden Eser Karlıdag,
  • Tugce Simsek Bozok,
  • Fatma Yekta Urkmez,
  • Tuba Ilgar,
  • Canan Demir,
  • Secil Deniz,
  • Derya Ozyigitoglu,
  • Nefise Oztoprak,
  • Safak Kaya,
  • Meltem Arzu Yetkin,
  • Yolanda Peña-López,
  • Jordi Rello,
  • Emine Alp Meşe,
  • Ali Aydin Altunkan,
  • Arif Timuroglu,
  • Ayse Capar,
  • Ayse Kok,
  • Ayse Yilmaz,
  • Basar Erdivanli,
  • Canan Dede,
  • Deniz Erdem,
  • Derya Yazici,
  • Ece Firuze Ozkan,
  • Emin Silay,
  • Emsal Aydin,
  • Gunhan Gokahmetoglu,
  • Hatice Aslan Sirakaya,
  • Hilal Sipahioglu,
  • Ilhami Celik,
  • Ismail Hakki Akbudak,
  • Kamil Deveci,
  • Koray Altun,
  • Levent Gorenek,
  • Maruf Boran,
  • Onur Hanbeyoglu,
  • Osman Ekinci,
  • Recep Civan Yuksel,
  • Safiye Taskin,
  • Oznur Ak,
  • Tulay Cici Teper,
  • Tulay Orhan,
  • Zahide Aşık,
  • Zehra Acamur,
  • Zeynep Ture,
  • Zuhal Avsar,
  • Zuhal Ozer Simsek

摘要

Background

Ventilator-associated infectious complications are the most prevalent healthcare-acquired infection in intensive care units. The surveillance of ventilator-associated events (VAE) has now supplanted traditional ventilator-associated pneumonia (VAP) monitoring. However, its use is not common and limited reports have been published. We aimed to describe the epidemiology, etiology and the prognosis of VAE.

Methods

This multicenter observational-descriptive study was conducted at 15 centers with active prospective surveillance of VAE. Their daily basis follow-up was for 90 days. The Centers for Disease Control and Prevention guideline 2015 update was used for the definition of VAE. VAE subdiagnosis was defined as ventilator-associated condition (VAC), infection-related ventilator-associated complication plus (IVAC-plus), infection-related ventilator-associated complications (IVAC), and possible ventilator-associated pneumonia (PVAP)

Results

A total of 185 VAE episodes developed in 174 of the 1018 patients included in the study. The VAE incidences per 1000 mechanical ventilation day were; VAC 2.33, IVAC-plus 6.0, IVAC 1.3 and PVAP 4.7. Additionally 158 VAP episodes (14.8%, 7.09/1000 MV days) were observed, 85 (45.9%, 4.99/1000 MV days) of them fit the definition of a concurrent VAE criteria.

Risk factors for VAE included a Sequential Organ Failure Assessment (SOFA) score greater than 7 on admission (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.23–2.47), the presence of a tracheostomy (OR:1.78; CI:1.19-2.65), and antibiotic use within the previous 90 days (OR:2.41; CI:1.09-4.20) were risk factors for VAE.

The mortality rate was 59.6% in ventilated patients. Multivariate analysis identified several risk factors for mortality, as follows: age greater than 63 years (OR: 1.75; CI: 1.26–2.42), a SOFA score greater than 5 on admission (OR: 2.00; CI: 1.47–1.46), a higher mean Charlson Comorbidity Index (OR: 1.08; CI: 1.02–1.13), being a medical-type patient (OR: 1.54; CI: 1.06–2.21), healthcare-associated infections (OR: 2.01; CI: 1.39–2.88), and the occurrence of VAE (OR: 2.21; CI: 1.04–4.70).

Conclusion

VAE is a common complication in intubated patients and is 2.21 times more likely to occur in intubated patients who die. Patients with a high SOFA score, tracheostomy and antibiotic use in the last 90 days are at increased risk. prevention of VAE in intubated patients is important for patient survival.