Details

Autor(en) / Beteiligte

• Galerneau, Louis-Marie
• Bailly, Sébastien
• Terzi, Nicolas
• Ruckly, Stéphane
• Garrouste-Orgeas, Maité
• Oziel, Johanna
• Hong Tuan Ha, Vivien
• Gainnier, Marc
• Siami, Shidasp
• Dupuis, Claire
• Forel, Jean-Marie
• Dartevel, Anaïs
• Dessajan, Julien
• Adrie, Christophe
• Goldgran-Toledano, Dany
• Laurent, Virginie
• Argaud, Laurent
• Reignier, Jean
• Pepin, Jean-Louis
• Darmon, Michael
• Timsit, Jean-François

Titel

Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP) in patients with acute exacerbation of COPD: From the French OUTCOMEREA cohort

Ist Teil von

• Critical care (London, England), 2023-09, Vol.27 (1), p.359-359, Article 359

Ort / Verlag

England: BioMed Central

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP), a nosocomial pneumonia that is not related to invasive mechanical ventilation (IMV), has been less studied than ventilator-associated pneumonia, and never in the context of patients in an ICU for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a common cause of ICU admission. This study aimed to determine the factors associated with NV-ICU-AP occurrence and assess the association between NV-ICU-AP and the outcomes of these patients. Data were extracted from the French ICU database, OutcomeRea™. Using survival analyses with competing risk management, we sought the factors associated with the occurrence of NV-ICU-AP. Then we assessed the association between NV-ICU-AP and mortality, intubation rates, and length of stay in the ICU. Of the 844 COPD exacerbations managed in ICUs without immediate IMV, NV-ICU-AP occurred in 42 patients (5%) with an incidence density of 10.8 per 1,000 patient-days. In multivariate analysis, prescription of antibiotics at ICU admission (sHR, 0.45 [0.23; 0.86], p = 0.02) and no decrease in consciousness (sHR, 0.35 [0.16; 0.76]; p < 0.01) were associated with a lower risk of NV-ICU-AP. After adjusting for confounders, NV-ICU-AP was associated with increased 28-day mortality (HR = 3.03 [1.36; 6.73]; p < 0.01), an increased risk of intubation (csHR, 5.00 [2.54; 9.85]; p < 0.01) and with a 10-day increase in ICU length of stay (p < 0.01). We found that NV-ICU-AP incidence reached 10.8/1000 patient-days and was associated with increased risks of intubation, 28-day mortality, and longer stay for patients admitted with AECOPD.