Mortality-associated factors in a cohort of children with ventilator-associated pneumonia in a Latin American pediatric hospital
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Abstract
Background: Bearing in mind that ventilator-associated pneumonia (VAP) is the second most common healthcare-associated infection, it is important to identify factors related to its mortality, even more so in countries with limited resources. Objective: to determine risk factors for mortality due to VAP. Methods: prospective simple cohort study conducted between January 2017 and December 2020 that included children between 1 month and 14 years. Demographic variables, the severity of admission, type of VAP, causative germs, indications for ventilation, comorbidities, and medical interventions were related to mortality due to VAP. The diagnosis of VAP was made based on the 2013 CDC definition. Results: 46 children with VAP were included in the analysis. Mortality was 34.8 %. The factors associated with mortality were: pSOFA (Pediatric Sequential Organ Failure Assessment Score) in the first 24 hours of admission greater than 7 points (3.3 % vs. 50 %; OR: 29.0; CI-95 % [3.1 – 267 .4]; p < 0.0001), Enterobacter cloacae infection (3.3 % vs. 37.5 %; OR: 17.1; 95 % CI [1.9 – 162.7]; p = 0.002) and VAT (ventilator-associated tracheobronchitis ) (16.7 % vs. 50 %; OR: 5.0; 95 % CI [1.3 – 19.7]; p = 0.017). Shock, multiple organ dysfunction syndrome (MODS), and sepsis were also associated. Conclusions: pSOFA, Enterobacter cloacae infection, VATS, shock, SDMO, and sepsis were associated with mortality in children with VAP.
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