Evidence map›Paper›PMID 39300386›Full record

ArticleBMC infectious diseases2024

Incidence and predictors of ventilator-associated pneumonia using a competing risk analysis: a single-center prospective cohort study in Egypt.

Mohamed Elsheikh, Akira Kuriyama, Yoshihito Goto, Yoshimitsu Takahashi, Mayumi Toyama, Yoshitaka Nishikawa, Mohamed Ahmed El Heniedy, Yasser Mohamed Abdelraouf, Hiroshi Okada, Takeo Nakayama

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Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

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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

6 citing papers in PubMed.

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4 · The record

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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

10 authors.

Mohamed ElsheikhDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Akira KuriyamaDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan. ak.bellyrub+005@gmail.com.
Yoshihito GotoDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Yoshimitsu TakahashiDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Mayumi ToyamaDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Yoshitaka NishikawaDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Mohamed Ahmed El HeniedyDepartment of Vascular Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
Yasser Mohamed AbdelraoufDepartment of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Hiroshi OkadaDepartment of Pharmaceutical Sciences, Wakayama Medical University, Wakayama, Japan.
Takeo NakayamaDepartment of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.

Funding

Japan Science and Technology Agency JPMJSP2110
6 · The paper itself

Abstract

backgroundVentilator-associated pneumonia (VAP) is a challenging nosocomial problem in low- and middle-income countries (LMICs) that face barriers to healthcare delivery and resource availability. This study aimed to examine the incidence and predictors of VAP in Egypt as an example of an LMIC while considering death as a competing event.

methodsThe study included patients aged ≥ 18 years who underwent mechanical ventilation (MV) in an intensive care unit (ICU) at a tertiary care, university hospital in Egypt between May 2020 and January 2023. We excluded patients who died or were transferred from the ICU within 48 h of admission. We determined the VAP incidence based on clinical suspicion, radiological findings, and positive lower respiratory tract microbiological cultures. The multivariate Fine-Gray subdistribution hazard model was used to examine the predictors of VAP while considering death as a competing event.

resultsOverall, 315 patients were included in this analysis. Sixty-two patients (19.7%) developed VAP (17.1 per 1000 ventilator days). The Fine-Gray subdistribution hazard model, after adjustment for potential confounders, revealed that emergency surgery (subdistribution hazard ratio [SHR]: 2.11, 95% confidence interval [CI]: 1.25-3.56), reintubation (SHR: 3.74, 95% CI: 2.23-6.28), blood transfusion (SHR: 2.23, 95% CI: 1.32-3.75), and increased duration of MV (SHR: 1.04, 95% CI: 1.03-1.06) were independent risk factors for VAP development. However, the new use of corticosteroids was not associated with VAP development (SHR: 0.94, 95% CI: 0.56-1.57). Klebsiella pneumoniae was the most common causative microorganism, followed by Pseudomonas aeruginosa.

conclusionThe incidence of VAP in Egypt was high, even in the ICU at a university hospital. Emergency surgery, reintubation, blood transfusion, and increased duration of MV were independently associated with VAP. Robust antimicrobial stewardship and infection control strategies are urgently needed in Egypt.

Indexed as

Pneumonia, Ventilator-AssociatedAdolescentAdultCohort StudiesCross InfectionEgyptFemaleHumansIncidenceKlebsiella pneumoniaeMalePneumonia, BacterialRisk FactorsSurvival AnalysisDeveloping countriesFine-Gray competing risk regression modelIncidencePneumonia, ventilator-associatedRespiration, artificialRisk factorsSubdistribution hazard ratio.

Identifiers

PMID39300386
PMCPMC11414232

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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.