title: Comparison of ventilator-associated pneumonia (VAP) rates between different ICUs: Implications of a zero VAP rate.
abstract: OBJECTIVE
  Ventilator-associated pneumonia (VAP) is associated with significant morbidity and mortality. Measures to reduce the incidence of VAP have resulted in institutions reporting a zero or near-zero VAP rates. The implications of zero VAP rates are unclear. This study was done to compare outcomes between two intensive care units (ICU) with one of them reporting a zero VAP rate.
  
  
  METHODS
  This study retrospectively compared VAP rates between two ICUs: Utah Valley Regional Medical Center (UVRMC) with 25 ICU beds and American Fork Hospital (AFH) with 9 ICU beds. Both facilities are under the same management and attended by a single group of intensivists. Both ICUs have similar nursing and respiratory staffing patterns. Both ICUs use the same intensive care program for reduction of VAP rates. ICU outcomes between AFH (reporting zero VAP rate) and UVRMC (VAP rate of 2.41/1000 ventilator days) were compared for the years 2007-2008.
  
  
  RESULTS
  UVRMC VAP rates during 2007 and 2008 were 2.31/1000 ventilator days and 2.5/1000 ventilator days respectively compared to a zero VAP rate at AFH. The total days of ventilation, mean days of ventilation per patient and mean duration of ICU stay per patient was higher in the UVRMC group as compared to AFH ICU group. There was no significant difference in mean age and APACHE II score between ICU patients at UVRMC and AFH. There was no statistical difference in rates of VAP and mortality between UVRMC and AFH.
  
  
  CONCLUSIONS
  During comparisons of VAP rate between institutions, a zero VAP rate needs to be considered in the context of overall ventilator days, mean durations of ventilator stay and ICU mortality.
authors: Department of Medicine, Utah Valley Regional Medical Center and University of Utah, Provo, UT 84604, USA. Krishna.sundar@imail.org
authors: Krishna M
authors: KM
authors: Sundar
authors: David
authors: D
authors: Nielsen
authors: Paul
authors: P
authors: Sperry
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006744:Hospital Bed Capacity, 100 to 299; D006745:Hospital Bed Capacity, 300 to 499; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D014589:Utah / Q000453:epidemiology