Comparative study of demographic profile, mortality, risk factors, and bacteriological profile of respiratory isolates from ventilated patients: Ventilator-associated event versus nonventilator-associated event cases

Introduction: Ventilator-associated pneumonia (VAP) rate has long been considered a quality indicator (QI) in intensive care units (ICUs) for mechanically ventilated patients. However, ever since the Centers for Disease Control and Prevention (CDC) redefined VAP as ventilator-associated events (VAEs), its validity as a tool for use in quality assurance needs to be assessed. Aim: The aim of the study was to identify VAE rate in ICU, compare the demographic and respiratory isolate profile and mortality with non-VAE cases, and identify risk factors for VAE. Materials and Methods: All ICU patients on mechanical ventilation (MV) for >2 days were followed prospectively. VAE data were collected using a checklist obtained from the CDC website (the National Healthcare Surveillance Network VAE surveillance tool). The demographic profile, risk factors, and treatment for each patient were recorded in a proforma. VAE rates were estimated per 1000 ventilator-days. Results: The overall VAE rate was 38.1/1000 MV days. Among VAE subtypes, 18.7% were ventilator-associated condition (VAC), 43.7% were infection-related VAC (IVAC), and 37.5% were possible VAP (PVAP). Survival rate was 100% for patients with VAC alone, whereas only 14.2% and 16.6% of patients survived with IVAC and PVAP, respectively. No significant association was found between age, gender, mortality, bacterial isolate, and VAE cases. Depressed level of consciousness, immunosuppression, antibiotic use, and reintubation were significant risk factors associated with VAE cases (P = 0.0001). Conclusion: There is no significant difference observed between VAE and non-VAE cases regarding demographic profile, respiratory bacterial profile, and mortality. More research is required to establish the role of VAE as a QI for patient care in ICUs.