Assessment of disease burden and risk factors associated with the development of ventilator associated pneumonia and its outcome in adult intensive care unit of tikur anbessa specialized hospital, Addis Ababa, Ethiopia, 2018
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Date
2018-06
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Addis Ababa Universty
Abstract
Background: Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in the ICU. Since no study were conducted, determining the incidence and factors associated with the development of VAP is important for implementing any preventive measures.
Objective: To assess the disease burden and factors associated with the development of ventilator associated pneumonia and its outcome in Adult Intensive Care Unit(AICU) of Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia,2018
Methodology: A retrospective cross-sectional study was conducted by using consecutive sampling method. All adult patients who were ventilated for >48 hours were included and patients with prior diagnosis of pneumonia. Secondary data was collected from patient card using structured information extracting tool. Binary and multiple logistic regression was employed to assess presence of any significant association between VAP and selected predictor variables. Continuous and categorical variables were compared using Student’s t test and Chi square. Where the P - value of <0.05 was considered significant.
Result: From the 164 patient VAP occurred in 40 (24.3%) patients. On multiple logistic
regression analysis, the identified risk factors were; Tracheostomy (AOR: 5.898, 95% CI: 1.312 -
26.525), re-intubation (AOR: 4.529, 95% CI: 1.337 – 15.337), admission to the medical ICU
(AOR: 5.154, 95% CI: 1.524 - 17.428), coma (AOR: 7.283, CI: 1.950 – 27.201), transportation
out of the ICU(AOR; 3.563, CI: 1.009 – 12.364), and continuous IV sedation use (AOR: 6.444, 95% CI: 1.791 – 23.186). Accinobacter and klebssiela pneumonia were the identified causative microorganisms. ICU length of stay was higher in patient with VAP than Non-VAP35.2 ± 27.5 vs 12.5 ± 12.16 days.
Conclusion and recommendation: the disease burdenof VAP in this study was found to be higher. Further prospective study is recommended to validate these outcomes and implementation of VAP bundle of prevention may decrease the incidence of VAP.
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Keywords
Incidence, Risk factor, TASH, Ventilator associated pneumonia