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Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients*.

Identifieur interne : 003810 ( PubMed/Curation ); précédent : 003809; suivant : 003811

Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients*.

Auteurs : Stijn Blot [Espagne] ; Despoina Koulenti ; George Dimopoulos ; Claude Martin ; Apostolos Komnos ; Wolfgang A. Krueger ; Giuseppe Spina ; Apostolos Armaganidis ; Jordi Rello

Source :

Critical care medicine [ 1530-0293 ] ; 2014.

RBID : pubmed:24158167

Descripteurs français

English descriptors

KwdEn :
- Age Distribution, Aged, Aged, 80 and over, Cause of Death, Cohort Studies, Critical Illness (mortality), Critical Illness (therapy), Europe, Female, Geriatric Assessment, Hospital Mortality (trends), Humans, Intensive Care Units, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Odds Ratio, Pneumonia, Ventilator-Associated (diagnosis), Pneumonia, Ventilator-Associated (epidemiology), Pneumonia, Ventilator-Associated (therapy), Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Survival Analysis.
MESH :
- geographic : Europe.
- diagnosis : Pneumonia, Ventilator-Associated.
- epidemiology : Pneumonia, Ventilator-Associated.
- mortality : Critical Illness.
- therapy : Critical Illness, Pneumonia, Ventilator-Associated.
- trends : Hospital Mortality.
- Age Distribution, Aged, Aged, 80 and over, Cause of Death, Cohort Studies, Female, Geriatric Assessment, Humans, Intensive Care Units, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Odds Ratio, Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Survival Analysis.

Abstract

We investigated the epidemiology of ventilator-associated pneumonia in elderly ICU patients. More precisely, we assessed prevalence, risk factors, signs and symptoms, causative bacterial pathogens, and associated outcomes.

DOI: 10.1097/01.ccm.0000435665.07446.50
PubMed: 24158167

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Le document en format XML

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<term>Odds Ratio</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
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<term>Cause de décès</term>
<term>Estimation de Kaplan-Meier</term>
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<term>Facteurs de risque</term>
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<term>Humains</term>
<term>Maladie grave ()</term>
<term>Maladie grave (mortalité)</term>
<term>Modèles de hasards proportionnels</term>
<term>Modèles logistiques</term>
<term>Mortalité hospitalière (tendances)</term>
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<term>Odds ratio</term>
<term>Pneumopathie infectieuse sous ventilation assistée ()</term>
<term>Pneumopathie infectieuse sous ventilation assistée (diagnostic)</term>
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</keywords>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cause of Death</term>
<term>Cohort Studies</term>
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<term>Geriatric Assessment</term>
<term>Humans</term>
<term>Intensive Care Units</term>
<term>Kaplan-Meier Estimate</term>
<term>Logistic Models</term>
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<term>Middle Aged</term>
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<term>Prognosis</term>
<term>Proportional Hazards Models</term>
<term>Prospective Studies</term>
<term>Risk Factors</term>
<term>Survival Analysis</term>
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<term>Analyse de survie</term>
<term>Cause de décès</term>
<term>Estimation de Kaplan-Meier</term>
<term>Europe</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
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<front><div type="abstract" xml:lang="en">We investigated the epidemiology of ventilator-associated pneumonia in elderly ICU patients. More precisely, we assessed prevalence, risk factors, signs and symptoms, causative bacterial pathogens, and associated outcomes.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24158167</PMID>
<DateCreated><Year>2014</Year>
<Month>02</Month>
<Day>18</Day>
</DateCreated>
<DateCompleted><Year>2014</Year>
<Month>04</Month>
<Day>22</Day>
</DateCompleted>
<DateRevised><Year>2014</Year>
<Month>04</Month>
<Day>24</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1530-0293</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>42</Volume>
<Issue>3</Issue>
<PubDate><Year>2014</Year>
<Month>Mar</Month>
</PubDate>
</JournalIssue>
<Title>Critical care medicine</Title>
<ISOAbbreviation>Crit. Care Med.</ISOAbbreviation>
</Journal>
<ArticleTitle>Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients*.</ArticleTitle>
<Pagination><MedlinePgn>601-9</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1097/01.ccm.0000435665.07446.50</ELocationID>
<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">We investigated the epidemiology of ventilator-associated pneumonia in elderly ICU patients. More precisely, we assessed prevalence, risk factors, signs and symptoms, causative bacterial pathogens, and associated outcomes.</AbstractText>
<AbstractText Label="DESIGN" NlmCategory="METHODS">Secondary analysis of a multicenter prospective cohort (EU-VAP project).</AbstractText>
<AbstractText Label="SETTING" NlmCategory="METHODS">Twenty-seven European ICUs.</AbstractText>
<AbstractText Label="PATIENTS" NlmCategory="METHODS">Patients who were mechanically ventilated for greater than or equal to 48 hours. We compared middle-aged (45-64 yr; n = 670), old (65-74 yr; n = 549), and very old patients (≥ 75 yr; n= 516).</AbstractText>
<AbstractText Label="MEASUREMENTS AND MAIN RESULTS" NlmCategory="RESULTS">Ventilator-associated pneumonia occurred in 103 middle-aged (14.6%), 104 old (17.0%), and 73 very old patients (12.8%). The prevalence (n ventilator-associated pneumonia/1,000 ventilation days) was 13.7 in middle-aged patients, 16.6 in old patients, and 13.0 in very old patients. Logistic regression analysis could not demonstrate older age as a risk factor for ventilator-associated pneumonia. Ventilator-associated pneumonia in elderly patients was more frequently caused by Enterobacteriaceae (24% in middle-aged, 32% in old, and 43% in very old patients; p = 0.042). Regarding clinical signs and symptoms at ventilator-associated pneumonia onset, new temperature rise was less frequent among very old patients (59% vs 76% and 74% for middle-aged and old patients, respectively; p = 0.035). Mortality among patients with ventilator-associated pneumonia was higher among elderly patients: 35% in middle-aged patients versus 51% in old and very old patients (p = 0.036). Logistic regression analysis confirmed the importance of older age in the risk of death (adjusted odds ratio for old age, 2.1; 95% CI, 1.2-3.9 and adjusted odds ratio for very old age, 2.3; 95% CI, 1.2-4.4). Other risk factors for mortality in ventilator-associated pneumonia were diabetes mellitus, septic shock, and a high-risk pathogen as causative agent.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In this multicenter cohort study, ventilator-associated pneumonia did not occur more frequently among elderly, but the associated mortality in these patients was higher. New temperature rise was less common in elderly patients with ventilator-associated pneumonia, whereas more episodes among elderly patients were caused by Enterobacteriaceae.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Blot</LastName>
<ForeName>Stijn</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>1Department of Internal Medicine, Ghent University, Ghent, Belgium. 2Attikon University Hospital, Athens, Greece. 3Critical Care Department, The Burns, Trauma, and Critical Care Research Center, The University of Queensland, Brisbane, QLD, Australia. 4Critical Care Department, Nord University Hospital, Marseille, France. 5Critical Care Department, General Hospital of Larisa, Larisa, Greece. 6Critical Care Department, Clinics of Constance, Constance, Germany. 7Department of Intensive Care, Mauriziano Hospital, Turin, Italy. 8Critical Care Department, Vall d'Hebron University Hospital, CIBERES, Universitat Autonoma de Barcelona, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Koulenti</LastName>
<ForeName>Despoina</ForeName>
<Initials>D</Initials>
</Author>
<Author ValidYN="Y"><LastName>Dimopoulos</LastName>
<ForeName>George</ForeName>
<Initials>G</Initials>
</Author>
<Author ValidYN="Y"><LastName>Martin</LastName>
<ForeName>Claude</ForeName>
<Initials>C</Initials>
</Author>
<Author ValidYN="Y"><LastName>Komnos</LastName>
<ForeName>Apostolos</ForeName>
<Initials>A</Initials>
</Author>
<Author ValidYN="Y"><LastName>Krueger</LastName>
<ForeName>Wolfgang A</ForeName>
<Initials>WA</Initials>
</Author>
<Author ValidYN="Y"><LastName>Spina</LastName>
<ForeName>Giuseppe</ForeName>
<Initials>G</Initials>
</Author>
<Author ValidYN="Y"><LastName>Armaganidis</LastName>
<ForeName>Apostolos</ForeName>
<Initials>A</Initials>
</Author>
<Author ValidYN="Y"><LastName>Rello</LastName>
<ForeName>Jordi</ForeName>
<Initials>J</Initials>
</Author>
<Author ValidYN="Y"><CollectiveName>EU-VAP Study Investigators</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Crit Care Med</MedlineTA>
<NlmUniqueID>0355501</NlmUniqueID>
<ISSNLinking>0090-3493</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Crit Care Med. 2014 Mar;42(3):742-4</RefSource>
<PMID Version="1">24534967</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="CommentIn"><RefSource>Crit Care Med. 2014 Apr;42(4):e314</RefSource>
<PMID Version="1">24633124</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="CommentIn"><RefSource>Crit Care Med. 2014 Apr;42(4):e314-5</RefSource>
<PMID Version="1">24633125</PMID>
</CommentsCorrections>
</CommentsCorrectionsList>
<MeshHeadingList><MeshHeading><DescriptorName UI="D017677" MajorTopicYN="N">Age Distribution</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002423" MajorTopicYN="Y">Cause of Death</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005060" MajorTopicYN="N" Type="Geographic">Europe</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015577" MajorTopicYN="N">Geriatric Assessment</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName>
<QualifierName UI="Q000639" MajorTopicYN="Y">trends</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007362" MajorTopicYN="Y">Intensive Care Units</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D053208" MajorTopicYN="N">Kaplan-Meier Estimate</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D053717" MajorTopicYN="N">Pneumonia, Ventilator-Associated</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
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<MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName>
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<MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<InvestigatorList><Investigator ValidYN="Y"><LastName>Annane</LastName>
<ForeName>Djilali</ForeName>
<Initials>D</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Amaya-Villar</LastName>
<ForeName>Rosario</ForeName>
<Initials>R</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Armaganidis</LastName>
<ForeName>Apostolos</ForeName>
<Initials>A</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Blot</LastName>
<ForeName>Stijn</ForeName>
<Initials>S</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Brun- Buisson</LastName>
<ForeName>Christian</ForeName>
<Initials>C</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Carneiro</LastName>
<ForeName>Antonio</ForeName>
<Initials>A</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Deja</LastName>
<ForeName>Maria</ForeName>
<Initials>M</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>DeWaele</LastName>
<ForeName>Jan</ForeName>
<Initials>J</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Diaz</LastName>
<ForeName>Emili</ForeName>
<Initials>E</Initials>
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	Serveur d'exploration sur les relations entre la France et l'Australie
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Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients*.

Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients*.

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