Medical News & Exposé
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Bryant Furlow, epiNewswire
June 11, 2010 — Hospital-acquired infections kill more than 90,000
Americans a year, according to the U.S. Centers for Disease Control
(CDC).
A leading source of those deadly infections is ventilator-associated
pneumonia (VAP). But published studies of VAP deaths have yielded
conflicting results, raising questions about the best way to prevent
infections and deaths.
Now, a new meta-analysis of mortality risk factors in adult VAP suggests
hospital policies and practices play a major role in whether or not a
patient survives.
The report, published in the current issue of the medical journal Shock,
pooled data from 26 previously published studies of VAP mortality.
Inappropriate initial treatment, such as the use of antibiotics to which the
bacteria is resistant or a delay of more than 24 hours in initiating
antibiotic therapy, nearly triples the patient's risk of dying, the study
found.
Late detection, after infections have already spread to the bloodstream,
also significantly increased patient death rate. Patients with sepsis when
VAP is diagnosed are nearly five times as likely to die as those without
sepsis (odds ratio: 4.77, 95% CI: 2.2 - 10.3).
Infections with gram-negative bacteria, particularly Acinetobacter
baumannii, increased mortality rates by 71 and 74 percent, respectively
(odds ratios: 1.71, 1.74; CIs > 1.0).
The results should "motivate clinicians to provide appropriate initial
treatment" and better manage sepsis, the authors wrote.
The meta-analysis was conducted by researchers at the Henry Dunant Hospital in
Athens, Greece and Tufts University in Boston, Mass. The authors did not disclose
any conflicts of interest.
June 11, 2010 — Hospital-acquired infections kill more than 90,000
Americans a year, according to the U.S. Centers for Disease Control
(CDC).
A leading source of those deadly infections is ventilator-associated
pneumonia (VAP). But published studies of VAP deaths have yielded
conflicting results, raising questions about the best way to prevent
infections and deaths.
Now, a new meta-analysis of mortality risk factors in adult VAP suggests
hospital policies and practices play a major role in whether or not a
patient survives.
The report, published in the current issue of the medical journal Shock,
pooled data from 26 previously published studies of VAP mortality.
Inappropriate initial treatment, such as the use of antibiotics to which the
bacteria is resistant or a delay of more than 24 hours in initiating
antibiotic therapy, nearly triples the patient's risk of dying, the study
found.
Late detection, after infections have already spread to the bloodstream,
also significantly increased patient death rate. Patients with sepsis when
VAP is diagnosed are nearly five times as likely to die as those without
sepsis (odds ratio: 4.77, 95% CI: 2.2 - 10.3).
Infections with gram-negative bacteria, particularly Acinetobacter
baumannii, increased mortality rates by 71 and 74 percent, respectively
(odds ratios: 1.71, 1.74; CIs > 1.0).
The results should "motivate clinicians to provide appropriate initial
treatment" and better manage sepsis, the authors wrote.
The meta-analysis was conducted by researchers at the Henry Dunant Hospital in
Athens, Greece and Tufts University in Boston, Mass. The authors did not disclose
any conflicts of interest.
Late diagnosis and treatment, Acinetobacter predict
hospital ventilator infection deaths (meta-analysis)
hospital ventilator infection deaths (meta-analysis)
Siempos II, Vardakas KZ, Kyriakopoulos CE, et al.
Predictors of mortality in adult patients with ventilator
associated pneumonia: a meta-analysis. Shock,
2010 (June);33(6):590-601.
Predictors of mortality in adult patients with ventilator
associated pneumonia: a meta-analysis. Shock,
2010 (June);33(6):590-601.
The Acinetobacter Threat
