The Risk Factors and Utilization of Trauma Patient with Ventilator-Associated Pneumonia (VAP)

Background and objectives:
Ventilator-associated pneumonia (VAP) not only is one of the important issues of infection control, but also an important complication affecting patients’ prognosis. The main purpose of this research is to analyze the risk factors of trauma patient with VAP and the association with medical care utilization.
Methods:
Data came from claims data file of 100 million sampled registry from Taiwan National Health Insurance Research Database from 2005 to 2007. A total of 1,010 trauma patients who received invasive mechanical ventilator for >48 hours were analyzed in this study. Differences were compared by using Wilcoxon signed-rank test and Chi-square test; Risk factors for VAP and assciation with medical care utilization were examined by using logistic regression and multiple linear regression.
Results:
Of the total of 1,010 patients, 166 (16.44%) developed VAP during hospitalization. Logistic regression analysis showed that age > 65, having sepsis and having longer duration of mechanical ventilation were factors associated with developing VAP. Trauma patients with VAP had significantly longer ICU stay (15 versus 10, P<0.001), and hospital stay (32 versus 23, P<0.001), and higher health care expenditure (NT$317,537 versus NT$255,427, P<0.001). Multiple linear regression analysis indicated that VAP significantly prolonged trauma patients’ ICU stay and hospital stay, but didn’t significantly increase patients’ expenditure and mortality rate after controlling for other factors.
Conclusions:
Age>65, suffering sepsis or long duration of mechanical ventilation were risk factors for developing VAP for trauma patients. VAP was associated with patients’ ICU stay and hospital stay.