VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME
Abstract Objective: To assess the incidence, risk factors and outcome of ventilator associated pneumonia in trauma patients. Study Design: Prospective observational study. Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, from Jul to Dec 2019. Metho...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Army Medical College Rawalpindi
2021-08-01
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| Series: | Pakistan Armed Forces Medical Journal |
| Subjects: | |
| Online Access: | https://pafmj.org/index.php/PAFMJ/article/view/6278 |
| _version_ | 1831761105979965440 |
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| author | Sohaima Manzoor Farzana Batool Muneeba Ahsan Sayeed Azizullah Khan Dhiloo Humera Muhammad Ismail Shehla Baqai |
| author_facet | Sohaima Manzoor Farzana Batool Muneeba Ahsan Sayeed Azizullah Khan Dhiloo Humera Muhammad Ismail Shehla Baqai |
| author_sort | Sohaima Manzoor |
| collection | DOAJ |
| description | Abstract
Objective: To assess the incidence, risk factors and outcome of ventilator associated pneumonia in trauma patients.
Study Design: Prospective observational study.
Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, from Jul to Dec 2019.
Methodology: All trauma patients, above 12 years, placed on mechanical ventilation in the emergency room or intensive care unit, were enrolled. Patients that developed a clinical pulmonary infection score of less than 6 were diagnosed with ventilator associated pneumonia.
Results: A total of 113 patients were enrolled in this study. Mean age was 32.9 ± 14.4 years. Thirty eight (33.6%) developed ventilator associated pneumonia. Patients with ventilator associated pneumonia, compared to non-ventilator associated pneumonia, had a longer emergency room stay of 7.8 ± 10.1 vs. 4.7 ± 7.4 days (p-value=0.013), greater ventilator days of 18.5 ± 12.6 vs. 7.9 ± 5.5 (p-value=0.001), longer hospital stay of >14 days in 65.8% vs. 33.3% (p-value=0.001) and higher mortality of 65.8% vs. 56% (p-value=0.213). Nurse to patient ratio and infection control measures for prevention of ventilator associated pneumonia were significantly reduced in emergency room compared to intensive care unit (p-value=0.001). Out of 43 respiratory isolates in 38 ventilator associated pneumonia patients, 40 (93%) were gram negatives of which 23 (57.5%) were multidrug resistant with polymyxins as the only therapeutic option.
Conclusion: There was a high incidence of ventilator associated pneumonia in patients with trauma. Prolonged retention in the emergency room is a significant risk factor for ventilator associated pneumonia, due to understaffing. |
| first_indexed | 2024-12-22T04:42:04Z |
| format | Article |
| id | doaj.art-1b7f49e03be34cc8803cabf3b2e8422a |
| institution | Directory Open Access Journal |
| issn | 0030-9648 2411-8842 |
| language | English |
| last_indexed | 2024-12-22T04:42:04Z |
| publishDate | 2021-08-01 |
| publisher | Army Medical College Rawalpindi |
| record_format | Article |
| series | Pakistan Armed Forces Medical Journal |
| spelling | doaj.art-1b7f49e03be34cc8803cabf3b2e8422a2022-12-21T18:38:42ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422021-08-0171414761480https://doi.org/10.51253/pafmj.v71i4.62786278VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOMESohaima Manzoor0Farzana Batool1Muneeba Ahsan Sayeed2Azizullah Khan Dhiloo3Humera Muhammad Ismail4Shehla Baqai5Shaheed Mohtarma Benazir Bhutto Institute of Taruma & Civil Hospital, Karachi PakistanShaheed Mohtarma Benazir Bhutto Institute of Taruma & Civil Hospital, Karachi PakistanShaheed Mohtarma Benazir Bhutto Institute of Taruma & Civil Hospital, Karachi PakistanDow University of Health Sciences, Karachi PakistanShaheed Mohtarma Benazir Bhutto Institute of Taruma & Civil Hospital, Karachi PakistanShaheed Mohtarma Benazir Bhutto Institute of Taruma & Civil Hospital, Karachi PakistanAbstract Objective: To assess the incidence, risk factors and outcome of ventilator associated pneumonia in trauma patients. Study Design: Prospective observational study. Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, from Jul to Dec 2019. Methodology: All trauma patients, above 12 years, placed on mechanical ventilation in the emergency room or intensive care unit, were enrolled. Patients that developed a clinical pulmonary infection score of less than 6 were diagnosed with ventilator associated pneumonia. Results: A total of 113 patients were enrolled in this study. Mean age was 32.9 ± 14.4 years. Thirty eight (33.6%) developed ventilator associated pneumonia. Patients with ventilator associated pneumonia, compared to non-ventilator associated pneumonia, had a longer emergency room stay of 7.8 ± 10.1 vs. 4.7 ± 7.4 days (p-value=0.013), greater ventilator days of 18.5 ± 12.6 vs. 7.9 ± 5.5 (p-value=0.001), longer hospital stay of >14 days in 65.8% vs. 33.3% (p-value=0.001) and higher mortality of 65.8% vs. 56% (p-value=0.213). Nurse to patient ratio and infection control measures for prevention of ventilator associated pneumonia were significantly reduced in emergency room compared to intensive care unit (p-value=0.001). Out of 43 respiratory isolates in 38 ventilator associated pneumonia patients, 40 (93%) were gram negatives of which 23 (57.5%) were multidrug resistant with polymyxins as the only therapeutic option. Conclusion: There was a high incidence of ventilator associated pneumonia in patients with trauma. Prolonged retention in the emergency room is a significant risk factor for ventilator associated pneumonia, due to understaffing.https://pafmj.org/index.php/PAFMJ/article/view/6278associated pneumoniagram negative bacteriaintensive care unitmulti drug resistancetrauma |
| spellingShingle | Sohaima Manzoor Farzana Batool Muneeba Ahsan Sayeed Azizullah Khan Dhiloo Humera Muhammad Ismail Shehla Baqai VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME Pakistan Armed Forces Medical Journal associated pneumonia gram negative bacteria intensive care unit multi drug resistance trauma |
| title | VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME |
| title_full | VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME |
| title_fullStr | VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME |
| title_full_unstemmed | VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME |
| title_short | VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME |
| title_sort | ventilator associated pneumonia in trauma patients associated risk factors microbial etiology and outcome |
| topic | associated pneumonia gram negative bacteria intensive care unit multi drug resistance trauma |
| url | https://pafmj.org/index.php/PAFMJ/article/view/6278 |
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