• Am. J. Surg. · Dec 2015

    Trauma-associated pneumonia: time to redefine ventilator-associated pneumonia in trauma patients.

    • Alicia J Mangram, Jacqueline Sohn, Nicolas Zhou, Alexzandra K Hollingworth, Francis R Ali-Osman, Joseph F Sucher, Melissa Moyer, and James K Dzandu.
    • HonorHealth John C. Lincoln Medical Center, Department of Trauma Services, 250 E Dunlap Avenue, Phoenix, AZ, USA. Electronic address: alicia.mangram@jcl.com.
    • Am. J. Surg. 2015 Dec 1; 210 (6): 1056-61; discussion 1061-2.

    BackgroundThe high prevalence of ventilator-associated pneumonia (VAP) in trauma patients has been reported in the literature, but the reasons for this observation remain unclear. We hypothesize that trauma factors play critical roles in VAP etiology.MethodsIn this retrospective study, 1,044 ventilated trauma patients were identified from December 2010 to December 2013. Patient-level trauma factors were used to predict pneumonia as study endpoint.ResultsNinety-five of the 1,044 ventilated trauma patients developed pneumonia. Rib fractures, pulmonary contusion, and failed prehospital intubation were significant predictors of pneumonia in a multivariate model.ConclusionsIt is time to redefine VAP in trauma patients based on the effect of rib fractures, pulmonary contusions, and failed prehospital intubations. The Centers for Disease Control and Prevention definition of VAP needs to be modified to reflect the effect of trauma factors in the etiology of trauma-associated pneumonia.Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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