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Τετάρτη 16 Μαΐου 2018

Trends of Incidence and Risk Factors of Ventilator-Associated Pneumonia in Elderly Patients Admitted to French ICUs Between 2007 and 2014*

imageObjectives: To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. Design: Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). Settings: Two-hundred fifty six ICUs in 246 settings in France. Patients: Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network. Interventions: Ventilator-associated pneumonia surveillance over time. Measurements and Main Results: Overall and multidrug-resistant organism–related ventilator-associated pneumonia incidence rates were expressed per 1,000 intubation days at risk. Age was stratified into three groups: young (18–64 yr old), old (65–74 yr old), and very old (75+ yr old). Age-stratified multivariate mixed-effects Poisson regressions were undertaken to assess trends of ventilator-associated pneumonia incidence over time, with center as the random effect. Ventilator-associated pneumonia risk factors were also evaluated. Of 206,223 patients, 134,510 were intubated: 47.8% were young, 22.3% were old, and 29.9% were very old. Ventilator-associated pneumonia incidence was lower in the very old group compared with the young group (14.51; 95% CI, 16.95–17.70 vs 17.32; 95% CI, 16.95–17.70, respectively, p

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