ArticleCritical care (London, England)2022
Effect of ICU quality control indicators on VAP incidence rate and mortality: a retrospective study of 1267 hospitals in China.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06834971 (Colistin Methanesulfonate Sodium Inhalation for Prophylaxis of Ventilator-Associated Pneumonia), which is not on this map. Cited by 10 papers.
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.
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.
Colistin Methanesulfonate Sodium Inhalation for Prophylaxis of Ventilator-Associated Pneumonia (CIVAP): A Prospective, Multicentre, Double-Blind, Randomized, Placebo-Controlled Trial
Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
- Short-term exposure to ambient fine particulate pollution aggravates ventilator-associated pneumonia in pediatric intensive care patients undergoing cardiovascular surgeries.Environmental health : a global access science source · 2023Trial
- Lower airway microbiota compositions and diversity among ventilator-associated pneumonia patients across COVID-19 epidemic phases: a retrospective study.Microbiology spectrum · 2025Article
- Novel Respiratory Breath Hold Index: A Predictor for Successful Extubation in Mechanically Ventilated Patients, a Prospective Cohort Study.Life (Basel, Switzerland) · 2025Article
- Microbiome-mediated colonization resistance to carbapenem-resistant Klebsiella pneumoniae in ICU patients.NPJ biofilms and microbiomes · 2025Article
- Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- EngineeredFrontiers in microbiology · 2025Article
- Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients-the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019.Frontiers of medicine · 2024Article
- Clinical Features and Outcomes of VAP Due to Multidrug-ResistantAntibiotics (Basel, Switzerland) · 2023Article
- Only the new beginning of VAP quality control.Critical care (London, England) · 2023Article
- Letter to the Editor regarding "Effect of ICU quality control indicators on VAP incidence rate and mortality: a retrospective study of 1267 hospitals in China".Critical care (London, England) · 2023Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
17 authors at 3 institutions in 1 country.
Funding
Abstract
purposeTo investigate the effects of ICU quality control indicators on the VAP incidence rate and mortality in China throughout 2019.
methodsThis was a retrospective study. A total of 1267 ICUs from 30 provinces in mainland China were included. Data were collected using the National Clinical Improvement System Data that report ICU information. Ten related quality control indicators were analyzed, including 5 structural factors (patient-to-bed ratio, physician-to-bed ratio, nurse-to-bed ratio, patient-to-physician ratio, and patient-to-nurse ratio), 3 process factors (unplanned endotracheal extubation rate, reintubation rate within 48 h, and microbiology detection rate before antibiotic use), and 2 outcome factors (VAP incidence rate and mortality). The information on the most common infectious pathogens and the most commonly used antibiotics in ICU was also collected. The Poisson regression model was used to identify the impact of factors on the incidence rate and mortality of VAP.
resultsThe incidence rate of VAP in these hospitals in 2019 was 5.03 (2.38, 10.25) per 1000 ventilator days, and the mortality of VAP was 11.11 (0.32, 26.00) %. The most common causative pathogen was Acinetobacter baumannii (in 39.98% of hospitals), followed by Klebsiella pneumoniae (38.26%), Pseudomonas aeruginosa, and Escherichia coli. In 26.90% of hospitals, third-generation cephalosporin was the most used antibiotic, followed by carbapenem (24.22%), penicillin and beta-lactamase inhibitor combination (20.09%), cephalosporin with beta-lactamase inhibitor (17.93%). All the structural factors were significantly associated with VAP incidence rate, but not with the mortality, although the trend was inconsistent. Process factors including unplanned endotracheal extubation rate, reintubation rate in 48 h, and microbiology detection rate before antibiotic use were associated with higher VAP mortality, while unplanned endotracheal extubation rate and reintubation rate in 48 h were associated with higher VAP mortality. Furthermore, K. pneumoniae as the most common pathogen was associated with higher VAP mortality, and carbapenems as the most used antibiotics were associated with lower VAP mortality.
conclusionThis study highlights the association between the ICU quality control (QC) factors and VAP incidence rate and mortality. The process factors rather than the structural factors need to be further improved for the QC of VAP in the ICU.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.