Incidence, Risk Factors, and Outcomes of Ventilator-Associated Pneumonia in Traumatic Brain Injury: A Meta-analysis

Ventilator-associated pneumonia (VAP) is one of the most severe complications in patients with traumatic brain injury (TBI) and is considered a risk factor for poor outcomes. However, the incidence of VAP among patients with TBI reported in studies varies widely. What is more, the risk factors and o...

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Published in:Neurocritical care Vol. 32; no. 1; pp. 272 - 285
Main Authors: Li, Yating, Liu, Chenxia, Xiao, Wei, Song, Tiantian, Wang, Shuhui
Format: Journal Article
Language:English
Published: New York Springer US 01.02.2020
Springer Nature B.V
Subjects:
Abbreviated Injury Scale
Barbiturates - therapeutic use
Blood Transfusion - statistics & numerical data
Brain Injuries, Traumatic - complications
Brain Injuries, Traumatic - therapy
Cohort analysis
Critical Care Medicine
Head injuries
Humans
Incidence
Infusions, Parenteral
Injury Severity Score
Intensive
Intensive Care Units
Internal Medicine
Length of stay
Length of Stay - statistics & numerical data
Medicine
Medicine & Public Health
Meta-analysis
Mortality
Neurology
Ostomy
Pneumonia
Pneumonia, Ventilator-Associated - complications
Pneumonia, Ventilator-Associated - epidemiology
Respiration, Artificial - statistics & numerical data
Review
Risk Factors
Smoking - epidemiology
Time Factors
Tracheostomy - statistics & numerical data
Trauma
Traumatic brain injury
Ventilators
France
Serbia
United States > US
China
Spain
Ventilator-associated pneumonia
Traumatic brain injury
Outcome
Risk factors
Incidence
ISSN:1541-6933, 1556-0961, 1556-0961
Online Access:Get full text
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Summary:Ventilator-associated pneumonia (VAP) is one of the most severe complications in patients with traumatic brain injury (TBI) and is considered a risk factor for poor outcomes. However, the incidence of VAP among patients with TBI reported in studies varies widely. What is more, the risk factors and outcomes of VAP are controversial. This study estimates the incidence, risk factors, and outcomes of VAP in patients with TBI and provides evidence for prevention and treatment. PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched from the earliest records to May 2018. Data involving the incidence, risk factors, and outcomes were extracted for meta-analysis. The results showed that the incidence of VAP was 36% (95% confidence interval (CI) 31–41%); risk factors analyses showed that smoking [odds ratio (OR) 2.13; 95% CI 1.16–3.92], tracheostomy (OR 9.55; 95% CI 3.24–28.17), blood transfusion on admission (OR 2.54; 95% CI 1.24–5.18), barbiturate infusion (OR 3.52; 95% CI 1.68–7.40), injury severity score (OR 4.65; 95% CI 1.96–7.34), and head abbreviated injury scale (OR 2.99; 95% CI 1.66–5.37) were related to the occurrence of VAP. When patients developed VAP, mechanical ventilation time (OR 5.45; 95% CI 3.78–7.12), ICU length of stay (OR 6.85; 95% CI 4.90–8.79), and hospital length of stay (OR 10.92; 95% CI 9.12–12.72) were significantly increased. However, VAP was not associated with an increased risk of mortality (OR 1.28; 95% CI 0.74–2.21). VAP is common in patients with TBI. It is affected by a series of factors and has a poor prognosis.
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ObjectType-Evidence Based Healthcare-3
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ISSN:1541-6933
1556-0961
1556-0961
DOI:10.1007/s12028-019-00773-w