D. Younan1, R. Griffin1, T. Swain1, B. Camins2 1University Of Alabama at Birmingham,Acute Care/ Surgery,Birmingham, Alabama, USA 2University Of Alabama at Birmingham,Infectious Diseases/ Medicine,Birmingham, Alabama, USA
Introduction: The Centers for Disease Control and Prevention replaced its old definition for ventilator associated pneumonia (VAP) with the Ventilator associated events (VAEs) algorithm in 2013. We sought to compare the outcome of trauma patients meeting the two definitions.
Methods: Trauma patients with blunt or penetrating injuries and at least 2 ventilator support days were identified using the trauma registry from 2013-2014. Ventilator associated pneumonia (VAP) was determined by using two
Methods: (1) pneumonia as defined by the “Old”, clinically based CDC definition and (2) pneumonia as defined by the updated “New” CDC definitions of Ventilator-Associated Events. For the current analysis, the latter definition of pneumonia included infection-related ventilator associated conditions (IVACs) and possible VAPs (PVAPs). Cohen’s Kappa statistic was determined to compare the two definitions for VAP. To compare demographic and clinical outcomes the chi-square and Kruskal-Wallis were used for categorical and continuous variables, respectively.
Results:From 2013-2014, there were 1170 trauma patients admitted for treatment who had at least 2 days of ventilator support. Of all, 144 (12.3%) met the “New” CDC definition for IVAC or PVAP, 358 (30.6%) met the “Old” definition of VAP, and 101 (8.6%) met “Both” definitions. The kappa statistic between pneumonia as currently defined under the “New” and “Old” definitions was 0.28 (95%CI 0.22-0.33). Between the definitions categories of VAP, there were no differences in age, gender, race, or injury severity score. Those meeting “Both” definitions had longer ventilator support days (p<0.0001), ICU length of stay (LOS) (p<0.0001), and hospital LOS (p<0.0001) when compared to those meeting only one definition. There was no difference in mortality for those meeting “Both” or just one definition for VAP.
Conclusion:There was no difference in mortality between patients meeting the “Old” and “New” definitions; those who met “Both” definitions had longer ventilator support days, ICU and hospital length of stay.