Tegegne Estibel Mengist, Chekol Gete Birhanu, Demissie Dereje Bayissa
School of Nursing, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Front Med (Lausanne). 2025 Apr 25;12:1500901. doi: 10.3389/fmed.2025.1500901. eCollection 2025.
Ventilator-associated pneumonia (VAP) occurs after 48 h of intubation or tracheostomy, leading to prolonged mechanical ventilation, increased healthcare costs, the emergence of antibiotic-resistant bacteria, and increased morbidity and mortality in resource-limited settings, including Ethiopia.
This study aimed to determine the prevalence of ventilator-associated pneumonia and identify associated factors among intubated adult patients admitted to public hospitals in Addis Ababa, Ethiopia, in 2024.
A facility-based retrospective study was conducted on 341 adult patients admitted to the intubated Intensive Care Unit (ICU) from 1 January 2021 to 30 December 2023. Variables with -values <0.05 in the bi-variable analysis were considered statistically significant.
A total of 335 patient charts were included in the study, with a response rate of 98.2%. More than half of the participants, 191 (57%), were male. The median age of patients was 40 years (IQR: 26-56 years). The study determined that the prevalence of ventilator-associated pneumonia (VAP) was 31.3% (95% CI: 26.3-36.4%). This study identified the following factors that increased the odds of ventilator-associated pneumonia: age of participants ≥60 years (AOR: 3.2, 95% CI: 1.51-7.12), re-intubation (AOR: 4.8, 95% CI: 2.4-9.4), duration of the patient on a mechanical ventilator (AOR: 3.2, 95% CI: 1.4-7.2), tracheostomy (AOR: 2.5, 95% CI: 1.2-5.2), and emergency intubation (AOR: 2.4, 95% CI: 1.3-4.6). These factors were significantly associated with VAP.
This study determined that nearly one-third of study participants developed VAP and identified factors that increased the odds of VAP, including: advanced age (AOR: 3.2, 95% CI: 1.51-7.12), re-intubation (AOR: 4.8, 95% CI: 2.4-9.4), duration of the patient on a mechanical ventilator (AOR: 3.2, 95% CI: 1.4-7.2), tracheostomy (AOR: 2.5, 95% CI: 1.2-5.2), and emergency intubation (AOR: 2.4, 95% CI: 1.3-4.6). Policymakers and health planners should address these factors to improve patient outcomes and healthcare costs among intubated adult patients admitted to public hospitals in Addis Ababa.
呼吸机相关性肺炎（VAP）发生在插管或气管切开术后48小时，导致机械通气时间延长、医疗成本增加、耐药菌出现，并增加了包括埃塞俄比亚在内的资源有限地区的发病率和死亡率。
本研究旨在确定2024年埃塞俄比亚亚的斯亚贝巴公立医院收治的成年插管患者中呼吸机相关性肺炎的患病率，并确定相关因素。
对2021年1月1日至2023年12月31日入住插管重症监护病房（ICU）的341例成年患者进行了一项基于机构的回顾性研究。在双变量分析中P值<0.05的变量被认为具有统计学意义。
本研究共纳入335份患者病历，回复率为98.2%。超过一半的参与者，即191人（57%）为男性。患者的中位年龄为40岁（四分位间距：26 - 56岁）。该研究确定呼吸机相关性肺炎（VAP）的患病率为31.3%（95%置信区间：26.3 - 36.4%）。本研究确定了以下增加呼吸机相关性肺炎发生几率的因素：参与者年龄≥60岁（调整后比值比：3.2，95%置信区间：1.51 - 7.12）、再次插管（调整后比值比：4.8，95%置信区间：2.4 - 9.4）、患者机械通气时间（调整后比值比：3.2，95%置信区间：1.4 - 7.2）、气管切开术（调整后比值比：2.5，95%置信区间：1.2 - 5.2）以及紧急插管（调整后比值比：2.4，95%置信区间：1.3 - 4.6）。这些因素与VAP显著相关。
本研究确定近三分之一的研究参与者发生了VAP，并确定了增加VAP发生几率的因素，包括：高龄（调整后比值比：3.2，95%置信区间：1.51 - 7.12）、再次插管（调整后比值比：4.8，95%置信区间：2.4 - 9.4）、患者机械通气时间（调整后比值比：3.2，95%置信区间：1.4 - 7.2）、气管切开术（调整后比值比：2.5，95%置信区间：1.2 - 5.2）以及紧急插管（调整后比值比：2.4，95%置信区间：1.3 - 4.6）。政策制定者和卫生规划者应解决这些因素，以改善埃塞俄比亚亚的斯亚贝巴公立医院收治的成年插管患者的治疗效果和医疗成本。
