Evidence map›Paper›PMID 36498679›Full record

ArticleJournal of clinical medicine2022

Incidence, Outcomes and Risk Factors of Recurrent Ventilator Associated Pneumonia in COVID-19 Patients: A Retrospective Multicenter Study.

Ines Gragueb-Chatti, Hervé Hyvernat, Marc Leone, Geoffray Agard, Noémie Peres, Christophe Guervilly, Mohamed Boucekine, Dany Hamidi, Laurent Papazian, Jean Dellamonica and 2 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Ines Gragueb-ChattiService de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, 13015 Marseille, France.
Hervé HyvernatService de Médecine Intensive-Réanimation, CHU Nice, 06202 Nice, France.
Marc LeoneService d'Anesthésie et de Réanimation, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, 13015 Marseille, France.ORCID 0000-0002-3097-758X
Geoffray AgardService de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, 13015 Marseille, France.ORCID 0000-0002-5095-6268
Noémie PeresService de Réanimation Polyvalente, Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer, 83056 Toulon, France.
Christophe GuervillyService de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, 13015 Marseille, France.
Mohamed BoucekineHealth Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005 Marseille, France.
Dany HamidiService de Médecine Intensive-Réanimation, CHU Nice, 06202 Nice, France.
Laurent PapazianService de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, 13015 Marseille, France.
Jean DellamonicaService de Médecine Intensive-Réanimation, CHU Nice, 06202 Nice, France.
Alexandre LopezService d'Anesthésie et de Réanimation, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, 13015 Marseille, France.
Sami HraiechService de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, 13015 Marseille, France.
Aix-Marseille Université · FRCentre Hospitalier Universitaire de Nice · FRHôpital Nord · FRCentre Hospitalier Intercommunal Toulon-La Seyne-sur-Mer · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: High incidence of ventilator associated pneumonia (VAP) has been reported in critically ill patients with COVID-19. Among these patients, we aimed to assess the incidence, outcomes and risk factors of VAP recurrences. Methods: We conducted an observational retrospective study in three French intensive care units (ICUs). Patients admitted for a documented COVID-19 from March 2020 to May 2021 and requiring mechanical ventilation (MV) for ≥48 h were included. The study main outcome was the incidence of VAP recurrences. Secondary outcomes were the duration of MV, ICU and hospital length of stay and mortality according to VAP and recurrences. We also assessed the factors associated with VAP recurrences. Results: During the study period, 398 patients met the inclusion criteria. A total of 236 (59%) of them had at least one VAP episode during their ICU stay and 109 (46%) of these patients developed at least one recurrence. The incidence of VAP recurrence considering death and extubation as competing events was 29.6% (IC = [0.250−0.343]). Seventy-eight percent of recurrences were due to the same bacteria (relapses). Patients with a VAP recurrence had a longer duration of MV as compared with one VAP and no VAP patients (41 (25−56) vs. 16 (8−30) and 10 (5−18) days; p < 0.001) and a longer ICU length of stay (46 (29−66) vs. 22 (12−36) and 14 (9−25) days; p < 0.001). The 90-day mortality was higher in the recurrence group as compared with the no VAP group only (31.2 vs. 21.0% (p = 0.021)). In a multivariate analysis including bacterial co-infection at admission, the use of immunosuppressive therapies and the bacteria responsible for the first VAP episode, the duration of MV was the only factor independently associated with VAP recurrence. Conclusion: In COVID-19 associated respiratory failure, recurrences affected 46% of patients with a first episode of VAP. VAP recurrences were mainly relapses and were associated with a prolonged duration of MV and ICU length of stay but not with a higher mortality. MV duration was the only factor associated with recurrences.

Indexed as

acute respiratory distress syndromeCOVID-19ICUrecurrence of VAPventilator-associated pneumonia

Identifiers

PMID36498679
PMCPMC9738672
OpenAlexW4311014085

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.