A comparison of clinical characteristics and outcomes of ventilator-associated pneumonias among burn patients by diagnostic criteria set

Duraid Younan, Russell Griffin, Thomas Swain, Eric Schinnerer, Jean Francois Pittet, Bernard Camins

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: The National Healthcare Safety Network (NHSN) replaced its old definition for ventilatorassociated pneumonia (VAP) with ventilator-associated events (VAEs) in 2013. Little data is available comparing the two definitions in burn patients. Methods: Data from 2011 to 2014 were collected on burn patients mechanically ventilated for at least 2 days. VAP was determined using two methods: (1) pneumonia as defined by the previous more clinical CDC (NHSN) definition captured in the burn registry; (2) pneumonia as defined by the recent CDC (NHSN) standard of VAEs where patients meeting the criteria for possible VAP were considered having a pneumonia. Cohen kappa statistic was measured to compare both definitions, and chi-square and ANOVA to compare admission and clinical outcomes. Results: There were 266 burn patients who were mechanically ventilated for at least 2 days between 2011 and 2014. One hundred patients (37.5%) met the criteria by the old definition and 35 (13.1%) met the criteria for both. The kappa statistic was 0.34 (95% confidence interval 0.23-0.45), suggesting weak agreement. Those who met both definitions were mechanically ventilated for a longer period of time (P = 0.0003), and had a longer intensive care unit (ICU) length of stay (LOS) (P = 0.0004) and hospital LOS (P = 0.0014). Conclusions: There is weak agreement between the two definitions of VAP in severely burn patients. However, patients who met both VAP definitions had longer ventilator days, ICU, and hospital stays.

Original languageEnglish
Pages (from-to)624-628
Number of pages5
JournalShock
Volume48
Issue number6
DOIs
StatePublished - 13 Jun 2017
Externally publishedYes

Keywords

  • Burn
  • Ventilator-associated events
  • Ventilator-associated pneumonia

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