Einstein (São Paulo) ()

Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study

  • Leonilda Giani Pontes,
  • Fernando Gatti de Menezes,
  • Priscila Gonçalves,
  • Alexandra do Rosário Toniolo,
  • Claudia Vallone Silva,
  • Julia Yaeko Kawagoe,
  • Camila Marques dos Santos,
  • Helena Maria Fernandes Castagna,
  • Marinês Dalla Valle Martino,
  • Luci Corrêa

DOI
https://doi.org/10.1590/s1679-45082017ao3865
Journal volume & issue
Vol. 15, no. 1
pp. 61 – 64

Abstract

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ABSTRACT Objective To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. Methods This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011. Results A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004). Conclusion Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis.

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