Mortality and Morbidity of Ventilator-Associated Pneumonia:The Controversy

Nosocomial infections occur in 20% of ICU patients (1), and are considered as an accurate indicator for quality in this speciality (2,3). The main risk factor, which is well known, is the length of ICU stay and of invasive devices (intravenous and urinary catheters, intratracheal accesses and mechanical ventilation). The severity of illness, as it can be easily assessed by severity scores such as Acute Physiologic and Chronic Health Evaluation (APACHE), Simplified Acute Physiologic Score (SAPS) or Mortality Prediction Moded (MPM), and the underlying condition of the patients, as it can be assessed by McCabe or Anaesthesia Society ofAmerica (ASA) scores are, two other very important risks factors for both nosocomial infections and mortality. Morbidity and mortality of nosocomial infections, in particular of ventilator-associated pneumonia (VAP), are considered to be very high in ICU patients (1,4,5,6,7). The excess in length ofstay and the extra costs are considerable (4,5,6). For all those reasons, nosocomial infections are considered a very significant public health problem.