title: Impact of ventilator associated pneumonia on outcome in patients with chronic obstructive pulmonary disease exacerbation.
abstract: OBJECTIVE
  There are sparse data regarding the impact of ventilator-associated pneumonia (VAP) on outcome among patients with chronic obstructive pulmonary disease (COPD) exacerbation.
  
  
  METHODS
  This retrospective study included patients with COPD exacerbation requiring endotracheal intubation for more than 48 h admitted in a single respiratory unit from January 2008 to December 2009. Records of these patients were checked for the occurrence of VAP.
  
  
  RESULTS
  One hundred and fifty-three patients required endotracheal intubation for COPD exacerbation during this period. The mean age of this cohort was 61.46 ± 11.3 years. The median duration of COPD was 6 years (range: 1-40). A total of 35 (22.8%) patients developed VAP (early: 9 and late: 26). The risk of mortality was comparable between two groups, that is, patients with and without VAP [odd's ratio (OR)-1.125; 95% confidence interval (CI), 0.622-2.035]. The duration of mechanical ventilation and hospital stay (median ± standard error, 95% CI) was 32 ± 10 (95% CI, 13-51) versus 10 ± 2 (95% CI, 6-14) days; P ≤ 0.001 and 53 ± 26 (95% CI, 3-103) versus 18 ± 7 (95% CI, 5-31) days; P = 0.031, respectively was higher among patients with VAP.
  
  
  CONCLUSIONS
  Our study has shown that VAP leads to increased duration of mechanical ventilation and hospital stay; however, the mortality is not affected.
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Hadda
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gopi Chand
authors.initials: GC
authors.lastname: Khilnani
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gajendra
authors.initials: G
authors.lastname: Dubey
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajkanna
authors.initials: R
authors.lastname: Nallan
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Guresh
authors.initials: G
authors.lastname: Kumar
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Randeep
authors.initials: R
authors.lastname: Guleria
keywords: Chronic obstructive pulmonary disease; endotracheal intubation; in-hospital mortality; ventilator-associated pneumonia