Mortality risk factors and the ventilator-associated pneumonia (VAP) in the ICU of a tertiary hospital in Indonesia
Abstract
Background & Objective: Mortality of patients with ventilator-associated pneumonia (VAP) in the ICU is influenced by several risk factors, including comorbidities, SOFA scores, malnutrition, and sepsis with multi-drug resistant (MDR) pathogens. We aimed to determine the risk factors for VAP patient mortality in the ICU of a tertiary hospital in Indonesia over a period of time.
Methodology: This descriptive observational study was conducted retrospectively in the ICU of Dr. Hasan Sadikin Hospital, Bandung, Indonesia, during 2021-2022. The hospital records of all patients diagnosed with VAP during this period were retrieved and the records of the deceased patients were analysed for various risk factors, which may have led to mortality.
Results: The results of this study showed that 64 patients experienced VAP, with 49 (76.6%) patients expired. The VAP patients who died were mostly male (63.3%), the median age was 61 years, median BMI of 22.2 kg/m2, with hospital length of stay (LOS) of 13 days, ICU LOS of 10 days, and ventilator LOS of 8 days. The majority had SOFA scores between 10-12 (46.9%), the PF ratio was 195.1 ± 77.5, albumin value was 2.11 ± 0.64. The most common comorbidity was hypertension (40.8%) with a high neutrophil-lymphocyte ratio (NLR) value (69.4%), the most common pathogen found was Acinetobacter baumannii (18.4%), and in the most of the patients experiencing MDR (53.3%), the cause of ICU admission was respiratory system disorders (40.8%). Bivariate analysis showed hospital LOS, ICU, ventilator, PF ratio, comorbidities, NLR, SOFA score, nutritional status, and MDR pathogens were associated with VAP mortality with P < 0.05.
Conclusion: This study concludes that the risk factors for mortality of VAP patients in the ICU of Dr. Hasan Sadikin Hospital, Bandung in 2021-2022 are comorbidities, a high neutrophil-lymphocyte ratio, SOFA score, poor nutritional status, and sepsis with multi-drug resistant pathogens. Identifying risk factors is essential for preventing and managing VAP in the ICU to reduce mortality.
Abbreviations: LOS - Length of Stay; MDR - Multi-Drug Resistant; NLR - Neutrophil-Lymphocyte Ratio; VAP - Ventilator-Associated Pneumonia
Keywords: Mortality, risk factors, ventilator-associated pneumonia (VAP)
Citation: Indriasari, Aditya R, Mizan Al-Haq M. Mortality risk factors and the ventilator-associated pneumonia (VAP) in the ICU of a tertiary hospital in Indonesia. Anaesth. pain intensive care 2024;28(2):206−213.
Received: November 01, 2023; Revised: February 08, 2024; Accepted: February 22, 2024
