Incidence rate and risk factors of ventilator-associated pneumonia in neurocritical patients with acute cerebrovascular diseases: A systematic review and meta-analysis of observational studies.

ObjectiveVentilator-associated pneumonia is a common complication among critically ill patients, particularly those with acute cerebrovascular diseases, including acute ischemic stroke, intracerebral hemorrhage, and aneurysmal subarachnoid hemorrhage. This study aimed to identify the factors associated with ventilator-associated pneumonia in patients with acute cerebrovascular diseases.MethodsA systematic review and meta-analysis were conducted using MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and Google Scholar. Studies involving patients aged ≥18 years who were hospitalized in an intensive care unit for >48 h, required mechanical ventilation, and had a primary diagnosis of ischemic stroke or aneurysmal subarachnoid hemorrhage were included. Risk of bias was assessed using a domain-based Risk of Bias in Non-randomized Studies of Interventions framework across all included studies, with complementary Newcastle-Ottawa Scale assessments for cohort and case-control studies. Data were analyzed using Review Manager. No publication-year restrictions were applied, and all eligible studies indexed up to the date of the final search were considered for inclusion.ResultsIn total, 16 studies involving 16,702 patients were included. The pooled incidence of ventilator-associated pneumonia was 31.62% (95% confidence interval: 24.82%-38.42%). Older age (≥65 years) (odds ratio: 2.74, 95% confidence interval: 1.68-4.48;