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Decreasing incidence and mortality among hospitalized patients suffering a ventilator-associated pneumonia: Analysis of the Spanish national hospital discharge database from 2010 to 2014.

Abstract The aim of this study was to describe trends in the incidence and outcomes of ventilator-associated pneumonia (VAP) among hospitalized patients in Spain (2010-2014).This is a retrospective study using the Spanish national hospital discharge database from year 2010 to 2014. We selected all hospital admissions that had an ICD-9-CM code: 997.31 for VAP in any diagnosis position. We analyzed incidence, sociodemographic and clinical characteristics, procedures, pathogen isolations, and hospital outcomes.We identified 9336 admissions with patients suffering a VAP. Incidence rates of VAP decreased significantly over time (from 41.7 cases/100,000 inhabitants in 2010 to 40.55 in 2014). The mean Charlson comorbidity index (CCI) was 1.08 ± 0.98 and it did not change significantly during the study period. The most frequent causative agent was Pseudomonas and there were not significant differences in the isolation of this microorganism over time. Time trend analyses showed a significant decrease in in-hospital mortality (IHM), from 35.74% in 2010 to 32.81% in 2014. Factor associated with higher IHM included male sex, older age, higher CCI, vein or artery occlusion, pulmonary disease, cancer, undergone surgery, emergency room admission, and readmission.This study shows that the incidence of VAP among hospitalized patients has decreased in Spain from 2010 to 2014. The IHM has also decreased over the study period. Further investigations are needed to improve the prevention and control of VAP.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28746223
OWN - NLM
STAT- MEDLINE
DA  - 20170726
DCOM- 20170807
LR  - 20170807
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - Decreasing incidence and mortality among hospitalized patients suffering a
      ventilator-associated pneumonia: Analysis of the Spanish national hospital
      discharge database from 2010 to 2014.
PG  - e7625
LID - 10.1097/MD.0000000000007625 [doi]
AB  - The aim of this study was to describe trends in the incidence and outcomes of
      ventilator-associated pneumonia (VAP) among hospitalized patients in Spain
      (2010-2014).This is a retrospective study using the Spanish national hospital
      discharge database from year 2010 to 2014. We selected all hospital admissions
      that had an ICD-9-CM code: 997.31 for VAP in any diagnosis position. We analyzed 
      incidence, sociodemographic and clinical characteristics, procedures, pathogen
      isolations, and hospital outcomes.We identified 9336 admissions with patients
      suffering a VAP. Incidence rates of VAP decreased significantly over time (from
      41.7 cases/100,000 inhabitants in 2010 to 40.55 in 2014). The mean Charlson
      comorbidity index (CCI) was 1.08 +/- 0.98 and it did not change significantly
      during the study period. The most frequent causative agent was Pseudomonas and
      there were not significant differences in the isolation of this microorganism
      over time. Time trend analyses showed a significant decrease in in-hospital
      mortality (IHM), from 35.74% in 2010 to 32.81% in 2014. Factor associated with
      higher IHM included male sex, older age, higher CCI, vein or artery occlusion,
      pulmonary disease, cancer, undergone surgery, emergency room admission, and
      readmission.This study shows that the incidence of VAP among hospitalized
      patients has decreased in Spain from 2010 to 2014. The IHM has also decreased
      over the study period. Further investigations are needed to improve the
      prevention and control of VAP.
FAU - de Miguel-Diez, Javier
AU  - de Miguel-Diez J
AD  - aRespiratory Department, Hospital General Universitario Gregorio Maranon,
      Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de
      Investigacion Sanitaria Gregorio Maranon (IiSGM) bPreventive Medicine and Public 
      Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos
      University cInternal Medicine Department, Hospital Universitario Clinico San
      Carlos dInternal Medicine Department, Hospital General Universitario Gregorio
      Maranon eEscuela Tecnica Superior de Ingenieros Industriales, Madrid, Spain.
FAU - Lopez-de-Andres, Ana
AU  - Lopez-de-Andres A
FAU - Hernandez-Barrera, Valentin
AU  - Hernandez-Barrera V
FAU - Jimenez-Trujillo, Isabel
AU  - Jimenez-Trujillo I
FAU - Mendez-Bailon, Manuel
AU  - Mendez-Bailon M
FAU - Miguel-Yanes, Jose M de
AU  - Miguel-Yanes JM
FAU - Del Rio-Lopez, Benito
AU  - Del Rio-Lopez B
FAU - Jimenez-Garcia, Rodrigo
AU  - Jimenez-Garcia R
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Databases, Factual
MH  - Female
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Patient Discharge
MH  - Pneumonia, Ventilator-Associated/*mortality/*therapy
MH  - Retrospective Studies
MH  - Sociobiology
MH  - Spain/epidemiology
EDAT- 2017/07/27 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007625 [doi]
AID - 00005792-201707280-00054 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7625. doi: 10.1097/MD.0000000000007625.