A comparison of clinical characteristics and outcomes of ventilator-associated pneumonias among burn patients by diagnostic criteria set

Academic Article

Abstract

  • © 2017 by the Shock Society. Objectives: The National Healthcare Safety Network (NHSN) replaced its old definition for ventilatorassociated pneumonia (VAP) with ventilator-associated events (VAEs) in 2013. Little data is available comparing the two definitions in burn patients. Methods: Data from 2011 to 2014 were collected on burn patients mechanically ventilated for at least 2 days. VAP was determined using two methods: (1) pneumonia as defined by the previous more clinical CDC (NHSN) definition captured in the burn registry; (2) pneumonia as defined by the recent CDC (NHSN) standard of VAEs where patients meeting the criteria for possible VAP were considered having a pneumonia. Cohen kappa statistic was measured to compare both definitions, and chi-square and ANOVA to compare admission and clinical outcomes. Results: There were 266 burn patients who were mechanically ventilated for at least 2 days between 2011 and 2014. One hundred patients (37.5%) met the criteria by the old definition and 35 (13.1%) met the criteria for both. The kappa statistic was 0.34 (95% confidence interval 0.23-0.45), suggesting weak agreement. Those who met both definitions were mechanically ventilated for a longer period of time (P = 0.0003), and had a longer intensive care unit (ICU) length of stay (LOS) (P = 0.0004) and hospital LOS (P = 0.0014). Conclusions: There is weak agreement between the two definitions of VAP in severely burn patients. However, patients who met both VAP definitions had longer ventilator days, ICU, and hospital stays.
  • Published In

  • Shock  Journal
  • Digital Object Identifier (doi)

    Pubmed Id

  • 11484214
  • Author List

  • Younan D; Griffin R; Swain T; Schinnerer E; Pittet JF; Camins B
  • Start Page

  • 624
  • End Page

  • 628
  • Volume

  • 48
  • Issue

  • 6