ArticleIntensive care medicine2010
Attributable mortality of ventilator-associated pneumonia: respective impact of main characteristics at ICU admission and VAP onset using conditional logistic regression and multi-state models.
Article in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.
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Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 184 citations in OpenAlex.
- A model-based cost-effectiveness analysis of Patient Blood Management.Blood transfusion = Trasfusione del sangue · 2019Pooled it
- Effect of Prior Atorvastatin Treatment on the Frequency of Hospital Acquired Pneumonia and Evolution of Biomarkers in Patients with Acute Ischemic Stroke: A Multicenter Prospective Study.BioMed research international · 2017Trial
- Linezolid plasma and intrapulmonary concentrations in critically ill obese patients with ventilator-associated pneumonia: intermittent vs continuous administration.Intensive care medicine · 2015Trial
- A phase 3 randomized double-blind comparison of ceftobiprole medocaril versus ceftazidime plus linezolid for the treatment of hospital-acquired pneumonia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Trial
- Impact of four sequential measures on the prevention of ventilator-associated pneumonia in cardiac surgery patients.Critical care (London, England) · 2014Trial
- Azithromycin to prevent Pseudomonas aeruginosa ventilator-associated pneumonia by inhibition of quorum sensing: a randomized controlled trial.Intensive care medicine · 2012Trial
- Early Detection of Ventilator-Associated Pneumonia in a Neurosurgical Patient: Do Biomarkers Help Us?Cureus · 2025Article
- Transforming Microbiological Diagnostics in Nosocomial Lower Respiratory Tract Infections: Innovations Shaping the Future.Diagnostics (Basel, Switzerland) · 2025Review
- Rebound Inverts theAntibiotics (Basel, Switzerland) · 2024Article
- Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia.Antibiotics (Basel, Switzerland) · 2024Review
- Nosocomial Infections in Adult Patients Supported by Extracorporeal Membrane Oxygenation in a Cardiac Intensive Care Unit.Microorganisms · 2023Article
- Ventilator-Associated Pneumonia in COVID-19 Patients Admitted in Intensive Care Units: Relapse, Therapeutic Failure and Attributable Mortality-A Multicentric Observational Study from the OutcomeRea Network.Journal of clinical medicine · 2023Article
- How to Use Nebulized Antibiotics in Severe Respiratory Infections.Antibiotics (Basel, Switzerland) · 2023Review
- Influence of Renal Dysfunction on the Differential Behaviour of Procalcitonin for the Diagnosis of Postoperative Infection in Cardiac Surgery.Journal of clinical medicine · 2022Article
- Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update.Infection control and hospital epidemiology · 2022Article
- Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia.Scientific reports · 2021Observational
- A comparison of diagnostic algorithms and clinical parameters to diagnose ventilator-associated pneumonia: a prospective observational study.BMC pulmonary medicine · 2021Observational
- Attributable Mortality of Ventilator-associated Pneumonia. Replicating Findings, Revisiting Methods.Annals of the American Thoracic Society · 2021Article
- In Vitro Antibacterial, Anti-Adhesive and Anti-Biofilm Activities ofAntibiotics (Basel, Switzerland) · 2021Article
- Comparison of three interventional approaches to prevent ventilator-associated pneumonia in intensive care units (ICUs): A clinical trial study.Qatar medical journal · 2021Article
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMethods for estimating the excess mortality attributable to ventilator-associated pneumonia (VAP) should handle VAP as a time-dependent covariate, since the probability of experiencing VAP increases with the time on mechanical ventilation. VAP-attributable mortality (VAP-AM) varies with definitions, case-mix, causative microorganisms, and treatment adequacy. Our objectives here were to compare VAP-AM estimates obtained using a traditional cohort analysis, a multistate progressive disability model, and a matched-cohort analysis; and to compare VAP-AM estimates according to VAP characteristics.
methodsWe used data from 2,873 mechanically ventilated patients in the Outcomerea database. Among these patients from 12 intensive care units, 434 (15.1%) experienced VAP; of the remaining patients, 1,969 (68.5%) were discharged alive and 470 (16.4%) died. With the multistate model, VAP-AM was 8.1% (95% confidence interval [95%CI], 3.1-13.1%) for 120 days' complete observation, compared to 10.4% (5.6-24.5%) using a matched-cohort approach (2,769 patients) with matching on mechanical ventilation duration followed by conditional logistic regression. VAP-AM was higher in surgical patients and patients with intermediate (but not high) Simplified Acute Physiologic Score II values at ICU admission. VAP-AM was significantly influenced by time to VAP but not by resistance of causative microorganisms. Higher Logistic Organ Dysfunction score at VAP onset dramatically increased VAP-AM (to 31.9% in patients with scores above 7).
conclusionA multistate model that appropriately handled VAP as a time-dependent event produced lower VAP-AM values than conditional logistic regression. VAP-AM varied widely with case-mix. Disease severity at VAP onset markedly influenced VAP-AM; this may contribute to the variability of previous estimates.
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