Using flexible methods to determine risk factors for ventilator-associated pneumonia in the Netherlands

• DOI: 10.1371/journal.pone.0218372
• Publication Date: 2019-06-20T17:36:55Z
• Authors: Tjallie I. I. van...; Hendriek Boshuizen; Jan C. Wille; Sabine C. de Greeff; Jaap T. van Dissel; Annelot F. Schoff...; Rolina D. van Gaalen
• Keywords: Ventilator-associated Pneumonia

Seven hospitals participated in the Dutch national surveillance for ventilator-associated pneumonia (VAP) and its risk factors. We analysed time-independent time-dependent factors VAP using standard Cox regression flexible Weighted Cumulative Effects method (WCE) that evaluates both current past exposures. The prospective of intensive care patients aged ≥16 years ventilated ≥48 hours resulted inclusion 940 primary ventilation periods, comprising 7872 days. average incidence density was 10.3/1000 Independent were age (16-40 at increased risk: HR 2.42 95% confidence interval 1.07-5.50), COPD (HR 0.19 [0.04-0.78]), sedation score (higher scores risk), selective oropharyngeal decontamination [0.04-0.91]), jet nebulizer (WCE, decreased intravenous antibiotics digestive tract (ivSDD, WCE, not SDD risk). protective effect ivSDD afforded 24 days with a delay 3 For some variables, WCE model preferable over proportional hazard regression. can furthermore increase insight into active time frame possible herein factor.