• O Leroy, J Guilley, H Georges, P Choisy, B Guery, S Alfandari, and G Beaucaire.
• Service de Réanimation Médicale et Maladies Infectieuses, Université de Lille, Centre Hospitalier, Tourcoing, France.
• J Crit Care. 1999 Mar 1; 14 (1): 12-9.

PurposeThe purpose of this article is to evaluate, using two pairwise case-control studies, attributable mortality linked to hospital-acquired ventilator-associated pneumonia (HA-VAP) complicating the intensive care unit (ICU) stay of patients exhibiting severe community-acquired pneumonia (CAP).Materials And MethodsOver an 11-year period, 498 patients with severe CAP were collected. Among them, 43 exhibited HA-VAP. In a first case-control study, these patients were matched with control on the basis of six confounding variables known to be general ICU prognosis factors. In a second case-control study, six variables specifically linked to CAP prognosis were used for matching.ResultsIn the two case-control studies, each case patient was matched with one control patient. In the first analysis, success of matching was achieved in 198 of 258 (77%) variables used for matching. In the second analysis, matching was successful for 242 of 258 (94%) confounding variables used. Eighteen patients died, compared with, respectively, 6 (P = .003) and 7 (P = .01) controls. Attributable mortality of HA-VAP was similar in the two pairwise analyses, respectively, 28% (risk ratio = 3.0; 95% confidence interval, 1.32 to 6.82) and 26% (risk ratio = 2.57; 95% confidence interval, 1.2 to 5.52).ConclusionWhen confounding factors were controlled, HA-VAP appeared to increase mortality of severe CAP requiring ICU admission.

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