Association of Hematocrit and Albumin Difference With Ventilator-Associated Pneumonia in Patients With Continuous Mechanical Ventilation: Evidence From MIMIC-IV Database.

Objective: This study aims to investigate the relationship between the difference in hematocrit and albumin (HCT-ALB) and ventilator-associated pneumonia (VAP) among patients undergoing continuous mechanical ventilation. Methods: This research utilized the data from the Medical Information Mart for Intensive Care IV database. The primary outcome was VAP occurred. HCT-ALB levels were divided into three groups according to the quantile: < -1.10; -1.10-5.30; ≥ 5.30. All patients with continuous mechanical ventilation were categorized into two groups: those who developed VAP and those who did not. Univariate and multivariate logistic regression analyses were used to assess the relationship between HCT-ALB and VAP risk. Receiver operating characteristic (ROC) curves were used to evaluate the predictive ability. To further assess the robustness of the findings, subgroup analyses were performed. Results: In our study, a total of 3021 patients were enrolled, and among them, 361 patients experienced VAP. Multivariate logistic regression showed that taking HCT-ALB < -1.10 as reference, HCT-ALB ≥ 5.30 was linked to an increased risk of VAP in patients undergoing continuous mechanical ventilation (odds ratio = 1.36, 95% confidence interval: 1.02-1.81). The ROC curve demonstrated approximately moderate predictive ability. This association remained robust in subgroups of male, quick Sepsis-Related Organ Failure Assessment score ≤ 2, not using antibiotics, having oral care, and no history of trauma injury, chronic obstructive pulmonary disease, or respiratory failure. Conclusion: HCT-ALB, as an easily measurable indicator, was associated with the risk of VAP in patients with continuous mechanical ventilation.