title: The Clinical Impact of Ventilator-Associated Events: A Prospective Multi-Center Surveillance Study.
abstract: OBJECTIVE
  The Centers for Disease Control and Prevention (CDC) has developed an approach to ventilator-associated events (VAE) surveillance. Using these methods, this study was performed to investigate VAE incidences and to test whether VAEs are associated with poorer outcomes in China.
  
  
  METHODS
  A 4-month, prospective multicenter surveillance study between April and July 2013.
  
  
  METHODS
  Our study included 15 adult intensive care units (ICUs) of 15 hospitals in China.
  
  
  METHODS
  Patients admitted to ICUs during the study period
  
  
  METHODS
  Patients on mechanical ventilation (MV) were monitored for VAEs: ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), and possible or probable ventilator-associated pneumonia (VAP). Patients with and without VACs were compared with regard to duration of MV, ICU length of stay (LOS), overall hospital LOS, and mortality rate.
  
  
  RESULTS
  During the study period, 2,356 of the 5,256 patients admitted to ICUs received MV for 8,438 ventilator days. Of these patients, 636 were on MV >2 days. VACs were identified in 94 cases (4.0%; 11.1 cases per 1,000 ventilator days), including 31 patients with IVACs and 16 with possible VAP but none with probable VAP. Compared with patients without VACs, patients with VACs had longer ICU LOS (by 6.2 days), longer duration on MV (by 7.7 days), and higher hospital mortality rate (50.0% vs 27.3%). The mortality rate attributable to VACs was 11.7%. Compared with those with VACs alone, patients with IVACs had longer duration on MV and increased ICU LOS but no higher mortality rates.
  
  
  CONCLUSIONS
  In China, surveillance of VACs and IVACs is able to identify MV patients with poorer outcomes. However, surveillance of possible and probable VAP can be problematic.
authors: 1Department of Infection Control,West China Hospital,Sichuan University,Chengdu,China.
authors: Shichao
authors: S
authors: Zhu
authors: 2Intensive Care Unit,West China Hospital,Sichuan University,Chengdu,China.
authors: Lin
authors: L
authors: Cai
authors: 4Department of Infection Control,Mianyang Central Hospital,Mianyang,China.
authors: Chunhua
authors: C
authors: Ma
authors: 5Department of Infection Control,The People's Hospital of Dujiangyang City,Chengdu,China.
authors: Hongmei
authors: H
authors: Zeng
authors: 6Department of Infection Control,The Third People's Hospital of Chengdu,Chengdu,China.
authors: Hua
authors: H
authors: Guo
authors: 7Department of Infection Control,Nanchong Central Hospital,Nanchong,China.
authors: Xiaoqing
authors: X
authors: Mao
authors: 8Department of Infection Control,The Second People's Hospital of Yibin City,Yibin,China.
authors: Chenghui
authors: C
authors: Zeng
authors: 9Department of Infection Control,The First People's Hospital of Neijing City,Neijiang,China.
authors: Xiaohong
authors: X
authors: Li
authors: 10Department of Infection Control,The People's Hospital of Deyang City,Deyang,China.
authors: Hua
authors: H
authors: Zhao
authors: 11Department of Infection Control,The Affiliated Hospital of North Sichuan Medical College,Nanchong,China.
authors: Yongfang
authors: Y
authors: Liu
authors: 12Department of Infection Control,Dazhou Central Hospital,Dazhou,China.
authors: Shilian
authors: S
authors: Liu
authors: 13Department of Infection Control,Bazhong Central Hospital,Bazhong.
authors: Juhua
authors: J
authors: Sun
authors: 14Department of Infection Control,Chengdu Military General Hospital,Chengdu,China.
authors: Ling
authors: L
authors: Zhang
authors: 15Department of Infection Control,The People's Hospital of Jiangyou City,Mianyang,China.
authors: Tingyong
authors: T
authors: Peng
authors: 16Department of Infection Control,The First Affiliated Hospital of Chengdu Medical College,Chengdu,China.
authors: Mina
authors: M
authors: Dong
authors: 17Department of Infection Control,The First People's Hospital of Yibin City,Yibin,China.
authors: Liping
authors: L
authors: Chen
authors: 1Department of Infection Control,West China Hospital,Sichuan University,Chengdu,China.
authors: Zhiyong
authors: Z
authors: Zong
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012122:Ventilators, Mechanical / Q000009:adverse effects* / Q000706:statistics & numerical data*