Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study

TÜRKOĞLU, Aybar Melda; İSKİT, Topeli Arzu

Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study

Aybar Melda TÜRKOĞLU, (Gazi Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Topeli Arzu İSKİT (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Tüberküloz ve Toraks

2 0

Yıl: 2008 Cilt: 56 Sayı: 2 Sayfa Aralığı: 139 - 149 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study

Öz:

Bu çalışmanın amacı, yüksek riskli mikroorganizmalarla gelişen ventilatörle ilişkili pnömoni (VİP)’nin sonuca etkisini incelemektir. Çalışmanın tipi: Eşleştirilmiş olgu-kontrol çalışması. Çalışma bir üniversite hastanesi dahiliye yoğun bakım ünitesinde gerçekleştirilmiştir. Pseudomonas aeruginosa, Acinetobacter spp., Stenotrophomonas maltophilia ve/veya metisiline dirençli Staphylococcus aureus yüksek riskli mikroorganizmalar olarak tanımlanmış olup, yüksek riskli mikroorganizmalarla VİP gelişen 35 hasta olgu grubu olarak kabul edilmiştir. VİP gelişmeyen 35 kontrol hastası APACHE II skoru, yaş, başvuru tarihi ve mekanik ventilasyon (MV) süresine göre eşleştirilmiştir. Yoğun bakım ve hastane mortalitesi olgu ve kontrol grubunda benzer olarak tespit edilmiştir (sırasıyla p= 0.58 ve p= 1.00). Ancak, olgu grubunda kontrol grubuna göre MV süresi [sırasıyla 18 (10-25) gün (medyan -çeyrekler arası aralık-) ve 8 (6-11) gün, p< 0.01], yoğun bakım [sırasıyla 20 (11-30) gün ve 13 (8-19) gün, p< 0.01] ve hastane yatış süresi [sırasıyla 29 (20-44) gün ve 22 (13-37) gün, p= 0.05] daha uzun olarak tespit edilmiştir. Yüksek riskli mikroorganizmalarla gelişen VİP’in her türlü etkenden bağımsız olarak yoğun bakım (OR: 6), hastane yatış süresi (OR: 4) ve MV süresini (OR: 11) uzatmakta olduğu tespit edilmiştir. Yüksek riskli mikroorganizmalarla gelişen VİP mortaliteyi önemli derecede etkilememektedir. Ancak, yoğun bakım ve hastane yatış süresini yedi gün, MV süresini 10 gün arttıran bağımsız bir risk faktörüdür

Anahtar Kelime: Zaman faktörleri Solunum, yapay Yatış süresi Pnömoni, bakteriyel Sonuç değerlendirilmesi (Sağlık bakımı) Olgu-kontrol çalışmaları Hastane ölüm oranı APACHE Yoğun bakım üniteleri

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Yüksek riskli mikroorganizmalarla gelişen ventilatörle ilişkili pnömoni: Eşleştirilmiş olgu-kontrol çalışması

Öz:

To determine the impact of ventilator-associated pneumonia (VAP) caused by high risk microorganisms (HRM) on patient outcome. Design: Matched case-control study. The study was conducted in a medical intensive care unit (ICU) of a university hospital. Thirty-five patients with VAP caused by HRM, including Pseudomonas aeruginosa, Acinetobacter spp., Stenotrophomonas maltophilia and/or methicillin-resistant Staphylococcus aureus were accepted as the case the patients. Thirty-five control patients, who did not develop VAP were matched to the case patients, according to APACHE II score, age, date of admission and duration of mechanical ventilation (MV). ICU and hospital mortality rates were similar between the case and the control patients (p= 0.58 and p= 1.00, respectively). However, length of ICU stay was longer in the case patients than in the control patients [20 (11-30) days (median -interquartile range-) and 13 (8-19) days, respectively; p< 0.01]. Length of hospital stay was also longer in the case patients than in the control patients [29 (20-44) days and 22 (13-37) days, respectively; p= 0.05]. In addition, duration of MV was longer in the case patients than in the control patients [18 (10-25) days and 8 (6-11) days, respectively; p< 0.01]. VAP caused by HRM independently prolonged ICU (OR: 6) and hospital stay (OR: 4) and duration of MV (OR: 11). VAP caused by HRM was not significantly associated with mortality. However, it was an independent risk factor, increasing length of ICU stay and hospital stay by seven days, and duration of MV by 10 days.

Anahtar Kelime: Outcome Assessment (Health Care) Case-Control Studies Hospital Mortality APACHE Intensive Care Units Time Factors Respiration, Artificial Length of Stay Pneumonia, Bacterial

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	TÜRKOĞLU A, İSKİT T (2008). Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. , 139 - 149.
Chicago	TÜRKOĞLU Aybar Melda,İSKİT Topeli Arzu Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. (2008): 139 - 149.
MLA	TÜRKOĞLU Aybar Melda,İSKİT Topeli Arzu Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. , 2008, ss.139 - 149.
AMA	TÜRKOĞLU A,İSKİT T Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. . 2008; 139 - 149.
Vancouver	TÜRKOĞLU A,İSKİT T Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. . 2008; 139 - 149.
IEEE	TÜRKOĞLU A,İSKİT T "Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study." , ss.139 - 149, 2008.
ISNAD	TÜRKOĞLU, Aybar Melda - İSKİT, Topeli Arzu. "Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study". (2008), 139-149.

APA	TÜRKOĞLU A, İSKİT T (2008). Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. Tüberküloz ve Toraks, 56(2), 139 - 149.
Chicago	TÜRKOĞLU Aybar Melda,İSKİT Topeli Arzu Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. Tüberküloz ve Toraks 56, no.2 (2008): 139 - 149.
MLA	TÜRKOĞLU Aybar Melda,İSKİT Topeli Arzu Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. Tüberküloz ve Toraks, vol.56, no.2, 2008, ss.139 - 149.
AMA	TÜRKOĞLU A,İSKİT T Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. Tüberküloz ve Toraks. 2008; 56(2): 139 - 149.
Vancouver	TÜRKOĞLU A,İSKİT T Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study. Tüberküloz ve Toraks. 2008; 56(2): 139 - 149.
IEEE	TÜRKOĞLU A,İSKİT T "Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study." Tüberküloz ve Toraks, 56, ss.139 - 149, 2008.
ISNAD	TÜRKOĞLU, Aybar Melda - İSKİT, Topeli Arzu. "Ventilator-associated pneumonia caused by high risk microorganisms: A matched case-control study". Tüberküloz ve Toraks 56/2 (2008), 139-149.