Rates of Ventilator-associated Pneumonia in Critically Ill Patients Haven’t Dropped Since 2005

Rates of Ventilator-associated Pneumonia in Critically Ill Patients Haven’t Dropped Since 2005

The number of critically ill patients who develop ventilator-associated pneumonia (VAP) has not declined significantly since 2005, a University of Connecticut (UConn) School of Medicine study reports.

This finding is not in agreement with data from the Centers of Disease Control and Prevention (CDC)’s National Healthcare Safety Network, which reported declining rates between 2006 and 2012 in both medical and surgical intensive care units.

The study, “Trend in Ventilator-Associated Pneumonia Rates Between 2005 and 2013,” was published in the Journal of the American Medical Association (JAMA).

VAP is a type of lung infection that develops in people who are on ventilators in hospitals. VAP typically affects critically ill patients who are in an intensive care unit (ICU), with studies indicating that up to 15 percent of patients who develop VAP may die from the infection.

“VAP is not going away; it still affects approximately one in 10 ventilated patients,” Dr. Mark L. Metersky of UConn Health’s Division of Pulmonary and Critical Care Medicine, and the study’s lead author, said in a news release. “Our findings are in stark contrast to the CDC’s report of a marked decline in VAP rates that had some believing it may no longer be an important problem.”

Using medical record data from the Medicare Patient Safety Monitoring System, Metersky and his colleagues analyzed VAP rates from 1,856 critically ill Medicare patients ages 65 and older, hospitalized in the United States from 2006 to 2012. All patients included in the analysis were placed on mechanical ventilation due to acute myocardial infarction (heart attack), heart failure, pneumonia, or surgical care.

Researchers found that the VAP rates in those seven years remained stable and substantial, affecting about 10 percent of critically ill ventilated patients. When researchers compared their results to the CDC’s National Healthcare Safety Network rates, there was no correlation; the CDC reported a decline in VAP rates during this period.

This study shows that VAP remains an important clinical problem and demonstrates the need for additional research on how to prevent and treat VAP.

“We have not beat this,” Metersky said. “Current hospital interventions that are used in an attempt to prevent VAP are not working. VAP is still a significant issue, and needs more examination into how we survey its occurrence and report it, along with more research into how best to prevent this type of pneumonia in vulnerable patient populations.”

The potential impact of VAP rates that are higher than expected may be leading patients to experience lung complications or even death, as well as spending more time on a ventilator or in the ICU. VAP slows patient recovery, increasing the use of antibiotics which may lead to potential resistance, and increases healthcare costs due to longer hospital stays.

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