title: Time-dependent analysis of extra length of stay and mortality due to ventilator-associated pneumonia in intensive-care units of ten limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC).
abstract: Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69,248 admissions followed for 283,069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2·03 days (95% CI 1·52-2·54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity.
authors.affiliation: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. victor_rosenthal@inicc.org
authors.forename: V D
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: F E
authors.initials: FE
authors.lastname: Udwadia
authors.forename: H J
authors.initials: HJ
authors.lastname: Muñoz
authors.forename: N
authors.initials: N
authors.lastname: Erben
authors.forename: F
authors.initials: F
authors.lastname: Higuera
authors.forename: K
authors.initials: K
authors.lastname: Abidi
authors.forename: E A
authors.initials: EA
authors.lastname: Medeiros
authors.forename: E
authors.initials: E
authors.lastname: Fernández Maldonado
authors.forename: S S
authors.initials: SS
authors.lastname: Kanj
authors.forename: A
authors.initials: A
authors.lastname: Gikas
authors.forename: A G
authors.initials: AG
authors.lastname: Barnett
authors.forename: N
authors.initials: N
authors.lastname: Graves
mesh_terms: D015331:Cohort Studies; D003906:Developing Countries / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D053717:Pneumonia, Ventilator-Associated / Q000401:mortality*; D012720:Severity of Illness Index