Impact of ventilator associated pneumonia on outcome in patients with chronic obstructive pulmonary disease exacerbation.

BACKGROUND AND OBJECTIVE

There are sparse data regarding the impact of ventilator-associated pneumonia (VAP) on outcome among patients with chronic obstructive pulmonary disease (COPD) exacerbation.

MATERIALS AND METHODS

This retrospective study included patients with COPD exacerbation requiring endotracheal intubation for more than 48 h admitted in a single respiratory unit from January 2008 to December 2009. Records of these patients were checked for the occurrence of VAP.

RESULTS

One hundred and fifty-three patients required endotracheal intubation for COPD exacerbation during this period. The mean age of this cohort was 61.46 ± 11.3 years. The median duration of COPD was 6 years (range: 1-40). A total of 35 (22.8%) patients developed VAP (early: 9 and late: 26). The risk of mortality was comparable between two groups, that is, patients with and without VAP [odd's ratio (OR)-1.125; 95% confidence interval (CI), 0.622-2.035]. The duration of mechanical ventilation and hospital stay (median ± standard error, 95% CI) was 32 ± 10 (95% CI, 13-51) versus 10 ± 2 (95% CI, 6-14) days; P ≤ 0.001 and 53 ± 26 (95% CI, 3-103) versus 18 ± 7 (95% CI, 5-31) days; P = 0.031, respectively was higher among patients with VAP.

CONCLUSIONS

Our study has shown that VAP leads to increased duration of mechanical ventilation and hospital stay; however, the mortality is not affected.