• Shichao Zhu, Lin Cai, Chunhua Ma, Hongmei Zeng, Hua Guo, Xiaoqing Mao, Chenghui Zeng, Xiaohong Li, Hua Zhao, Yongfang Liu, Shilian Liu, Juhua Sun, Ling Zhang, Tingyong Peng, Mina Dong, Liping Chen, and Zhiyong Zong.
• 1Department of Infection Control,West China Hospital,Sichuan University,Chengdu,China.
• Infect Control Hosp Epidemiol. 2015 Dec 1; 36 (12): 1388-95.

ObjectiveThe Centers for Disease Control and Prevention (CDC) has developed an approach to ventilator-associated events (VAE) surveillance. Using these methods, this study was performed to investigate VAE incidences and to test whether VAEs are associated with poorer outcomes in China.DesignA 4-month, prospective multicenter surveillance study between April and July 2013.SettingOur study included 15 adult intensive care units (ICUs) of 15 hospitals in China.PatientsPatients admitted to ICUs during the study periodMethodsPatients on mechanical ventilation (MV) were monitored for VAEs: ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), and possible or probable ventilator-associated pneumonia (VAP). Patients with and without VACs were compared with regard to duration of MV, ICU length of stay (LOS), overall hospital LOS, and mortality rate.ResultsDuring the study period, 2,356 of the 5,256 patients admitted to ICUs received MV for 8,438 ventilator days. Of these patients, 636 were on MV >2 days. VACs were identified in 94 cases (4.0%; 11.1 cases per 1,000 ventilator days), including 31 patients with IVACs and 16 with possible VAP but none with probable VAP. Compared with patients without VACs, patients with VACs had longer ICU LOS (by 6.2 days), longer duration on MV (by 7.7 days), and higher hospital mortality rate (50.0% vs 27.3%). The mortality rate attributable to VACs was 11.7%. Compared with those with VACs alone, patients with IVACs had longer duration on MV and increased ICU LOS but no higher mortality rates.ConclusionsIn China, surveillance of VACs and IVACs is able to identify MV patients with poorer outcomes. However, surveillance of possible and probable VAP can be problematic.

25 keywords...

hide…