Rosenthal, Victor Daniel and Yin, Ruijie and Rodrigues, Camilla and Myatra, Sheila Nainan and Divatia, Jigeeshu Vasishth and Biswas, Sanjay K. and Shrivastava, Anjana Mahesh and Kharbanda, Mohit and Nag, Bikas and Mehta, Yatin and Sarma, Smita and Todi, Subhash Kumar and Bhattacharyya, Mahuya and Bhakta, Arpita and Gan, Chin Seng and Low, Michelle Siu Yee and Kushairi, Marissa Bt Madzlan and Chuah, Soo Lin and Wang, Qi Yuee and Chawla, Rajesh and Jain, Aakanksha Chawla and Kansal, Sudha and Bali, Roseleen Kaur and Arjun, Rajalakshmi and Davaadagva, Narangarav and Bat-Erdene, Batsuren and Begzjav, Tsolmon and Basri, Mat Nor Mohd and Tai, Chian-Wern and Lee, Pei-Chuen and Tang, Swee-Fong and Sandhu, Kavita and Badyal, Binesh and Arora, Ankush and Sengupta, Deep and Tao, Lili and Jin, Zhilin (2023) Multinational prospective cohort study over 18 years of the risk factors for ventilator-associated pneumonia in 9 Asian countries: INICC findings. American Journal Of Infection Control, 51 (7). pp. 751-757. ISSN 0196-6553, DOI https://doi.org/10.1016/j.ajic.2022.11.005.
Full text not available from this repository.Abstract
Background: Ventilator associated pneumonia (VAP) rates in Asia are several times above those of US. The objective of this study is to identify VAP risk factors. Methods: We conducted a prospective cohort study, between March 27, 2004 and November 2, 2022, in 279 ICUs of 95 hospitals in 44 cities in 9 Asian countries (China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, Vietnam). Results: 153,717 patients, followed during 892,996 patient-days, acquired 3,369 VAPs. We analyzed 10 independent variables. Using multiple logistic regression we identified following independent VAP RFs= Age, rising VAP risk 1% per year (aOR=1.01; 95%CI=1.00-1.01, P<.0001); male gender (OR=1.17; 95%CI=1.08-1.26, P<.0001); length of stay, rising VAP risk 7% daily (aOR=1.07; 95%CI=1.06-1.07, P<.0001); mechanical ventilation (MV) device utilization (DU) ratio (OR=1.43; 95%CI=1.36-1.51; p<.0001); tracheostomy connected to a MV (OR=11.17; 95%CI=9.55-14.27; p<.0001); public (OR=1.84; 95%CI=1.49-2.26, P<.0001), and private (OR=1.57; 95%CI=1.29-1.91, P<.0001) compared with teaching hospitals; upper-middle income country (OR=1.86; 95%CI=1.63-2.14, P<.0001). Regarding ICUs, Medical-Surgical (OR=4.61; 95%CI=3.43-6.17; P<.0001), Neurologic (OR=3.76; 95%CI=2.43-5.82; P<.0001), Medical (OR=2.78; 95%CI=2.04-3.79; P<.0001), and Neuro-Surgical (OR=2.33; 95%CI=1.61-3.92; P<.0001) showed the highest risk. Conclusions: Some identified VAP RFs are unlikely to change= age, gender, ICU type, facility ownership, country income level. Based on our results, we recommend limit use of tracheostomy, reducing LOS, reducing the MV/DU ratio, and implementing an evidence-based set of VAP prevention recommendations. (c) 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | INICC Advisory Board |
| Uncontrolled Keywords: | Intensive care unit; Nosocomial pneumonia; Low and middle income countries; Limited resources countries; International nosocomial infection control consortium |
| Subjects: | G Geography. Anthropology. Recreation > GE Environmental Sciences R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 08 Nov 2025 09:51 |
| Last Modified: | 08 Nov 2025 09:51 |
| URI: | http://eprints.um.edu.my/id/eprint/49757 |
Actions (login required)
 |
View Item |
