The effect of ventilator-associated pneumonia on the prognosis of head trauma patients.
BACKGROUND
To investigate the effect of ventilator-associated pneumonia (VAP) on the prognosis of head trauma patients.


METHODS
We performed a retrospective case-control study in which 57 head trauma patients with VAP were matched to 57 head trauma patients without VAP. Matching criteria were age (+/-5 years), Glasgow Coma Scale score (+/-2), Injury Severity Score (+/-5), Simplified Acute Physiology Score II (+/-5), and duration of exposure to mechanical ventilation.


RESULTS
The most causative organisms of VAP were Pseudomonas aeruginosa, and Acinetobactor baumannii (36.8% and 33.8% of isolated organisms, respectively). The duration of mechanical ventilation, intensive care unit stay, and hospital stay were significantly increased in case patients (13 +/- 8.4, 24.5 +/- 18, and 30.8 +/- 18.6 days, respectively) compared with control patients (8.3 +/- 4.3, 12.3 +/- 8, and 20.3 +/- 18.7 days, respectively). Mortality rate was also higher in case (29.8%) than in control (12.3%) patients (p = 0.02).


CONCLUSIONS
We conclude that the occurrence of VAP caused by high-risk organisms in cranial trauma patients may increase the risk of death, the mechanical ventilation duration, the intensive care unit stay, and the hospital stay.
Kallel
Hatem
H
Service de Réanimation Médicale, Intensive Care Unit, Sfax, Tunisia.
Chelly
Hedi
H
Bahloul
Mabrouk
M
Ksibi
Hichem
H
Dammak
Hassan
H
Chaari
Adel
A
Ben Hamida
Chokri
C
Rekik
Noureddine
N
Bouaziz
Mounir
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D012306:Risk; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology