Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP) in patients with acute exacerbation of COPD : From the French OUTCOMEREA cohort
© 2023. BioMed Central Ltd., part of Springer Nature..
BACKGROUND: Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP), a nosocomial pneumonia that is not related to invasive mechanical ventilation (IMV), has been less studied than ventilator-associated pneumonia, and never in the context of patients in an ICU for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a common cause of ICU admission. This study aimed to determine the factors associated with NV-ICU-AP occurrence and assess the association between NV-ICU-AP and the outcomes of these patients.
METHODS: Data were extracted from the French ICU database, OutcomeRea™. Using survival analyses with competing risk management, we sought the factors associated with the occurrence of NV-ICU-AP. Then we assessed the association between NV-ICU-AP and mortality, intubation rates, and length of stay in the ICU.
RESULTS: Of the 844 COPD exacerbations managed in ICUs without immediate IMV, NV-ICU-AP occurred in 42 patients (5%) with an incidence density of 10.8 per 1,000 patient-days. In multivariate analysis, prescription of antibiotics at ICU admission (sHR, 0.45 [0.23; 0.86], p = 0.02) and no decrease in consciousness (sHR, 0.35 [0.16; 0.76]; p < 0.01) were associated with a lower risk of NV-ICU-AP. After adjusting for confounders, NV-ICU-AP was associated with increased 28-day mortality (HR = 3.03 [1.36; 6.73]; p < 0.01), an increased risk of intubation (csHR, 5.00 [2.54; 9.85]; p < 0.01) and with a 10-day increase in ICU length of stay (p < 0.01).
CONCLUSION: We found that NV-ICU-AP incidence reached 10.8/1000 patient-days and was associated with increased risks of intubation, 28-day mortality, and longer stay for patients admitted with AECOPD.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Critical care (London, England) - 27(2023), 1 vom: 19. Sept., Seite 359 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Galerneau, Louis-Marie [VerfasserIn] |
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| Links: |
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| Themen: |
Acute exacerbation of chronic obstructive pulmonary disease |
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| Anmerkungen: |
Date Completed 21.09.2023 Date Revised 09.04.2024 published: Electronic ErratumIn: Crit Care. 2024 Apr 9;28(1):117. - PMID 38594747 Citation Status MEDLINE |
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| doi: |
10.1186/s13054-023-04631-2 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP) in patients with acute exacerbation of COPD |b From the French OUTCOMEREA cohort |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 21.09.2023 | ||
| 500 | |a Date Revised 09.04.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a ErratumIn: Crit Care. 2024 Apr 9;28(1):117. - PMID 38594747 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. BioMed Central Ltd., part of Springer Nature. | ||
| 520 | |a BACKGROUND: Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP), a nosocomial pneumonia that is not related to invasive mechanical ventilation (IMV), has been less studied than ventilator-associated pneumonia, and never in the context of patients in an ICU for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a common cause of ICU admission. This study aimed to determine the factors associated with NV-ICU-AP occurrence and assess the association between NV-ICU-AP and the outcomes of these patients | ||
| 520 | |a METHODS: Data were extracted from the French ICU database, OutcomeRea™. Using survival analyses with competing risk management, we sought the factors associated with the occurrence of NV-ICU-AP. Then we assessed the association between NV-ICU-AP and mortality, intubation rates, and length of stay in the ICU | ||
| 520 | |a RESULTS: Of the 844 COPD exacerbations managed in ICUs without immediate IMV, NV-ICU-AP occurred in 42 patients (5%) with an incidence density of 10.8 per 1,000 patient-days. In multivariate analysis, prescription of antibiotics at ICU admission (sHR, 0.45 [0.23; 0.86], p = 0.02) and no decrease in consciousness (sHR, 0.35 [0.16; 0.76]; p < 0.01) were associated with a lower risk of NV-ICU-AP. After adjusting for confounders, NV-ICU-AP was associated with increased 28-day mortality (HR = 3.03 [1.36; 6.73]; p < 0.01), an increased risk of intubation (csHR, 5.00 [2.54; 9.85]; p < 0.01) and with a 10-day increase in ICU length of stay (p < 0.01) | ||
| 520 | |a CONCLUSION: We found that NV-ICU-AP incidence reached 10.8/1000 patient-days and was associated with increased risks of intubation, 28-day mortality, and longer stay for patients admitted with AECOPD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute exacerbation of chronic obstructive pulmonary disease | |
| 650 | 4 | |a Intensive care medicine | |
| 650 | 4 | |a Non-ventilator-associated ICU-acquired pneumonia | |
| 650 | 4 | |a Prevalence | |
| 650 | 4 | |a Prognosis | |
| 700 | 1 | |a Bailly, Sébastien |e verfasserin |4 aut | |
| 700 | 1 | |a Terzi, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Ruckly, Stéphane |e verfasserin |4 aut | |
| 700 | 1 | |a Garrouste-Orgeas, Maité |e verfasserin |4 aut | |
| 700 | 1 | |a Oziel, Johanna |e verfasserin |4 aut | |
| 700 | 1 | |a Hong Tuan Ha, Vivien |e verfasserin |4 aut | |
| 700 | 1 | |a Gainnier, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Siami, Shidasp |e verfasserin |4 aut | |
| 700 | 1 | |a Dupuis, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Forel, Jean-Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Dartevel, Anaïs |e verfasserin |4 aut | |
| 700 | 1 | |a Dessajan, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Adrie, Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Goldgran-Toledano, Dany |e verfasserin |4 aut | |
| 700 | 1 | |a Laurent, Virginie |e verfasserin |4 aut | |
| 700 | 1 | |a Argaud, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Reignier, Jean |e verfasserin |4 aut | |
| 700 | 1 | |a Pepin, Jean-Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Darmon, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Timsit, Jean-François |e verfasserin |4 aut | |
| 700 | 0 | |a OUTCOME R. E. A. network |e verfasserin |4 aut | |
| 700 | 1 | |a Timsit, Jean-François |e investigator |4 oth | |
| 700 | 1 | |a Azoulay, Elie |e investigator |4 oth | |
| 700 | 1 | |a Garrouste-Orgeas, Maïté |e investigator |4 oth | |
| 700 | 1 | |a Zahar, Jean-Ralph |e investigator |4 oth | |
| 700 | 1 | |a Mourvillier, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Darmon, Michael |e investigator |4 oth | |
| 700 | 1 | |a Alberti, Corinne |e investigator |4 oth | |
| 700 | 1 | |a Ruckly, Stephane |e investigator |4 oth | |
| 700 | 1 | |a Bailly, Sébastien |e investigator |4 oth | |
| 700 | 1 | |a Vannieuwenhuyze, Aurélien |e investigator |4 oth | |
| 700 | 1 | |a Adrie, Christophe |e investigator |4 oth | |
| 700 | 1 | |a Agasse, Carole |e investigator |4 oth | |
| 700 | 1 | |a Allaouchiche, Bernard |e investigator |4 oth | |
| 700 | 1 | |a Andremont, Olivier |e investigator |4 oth | |
| 700 | 1 | |a Andreu, Pascal |e investigator |4 oth | |
| 700 | 1 | |a Argaud, Laurent |e investigator |4 oth | |
| 700 | 1 | |a Ara-Somohano, Claire |e investigator |4 oth | |
| 700 | 1 | |a Azoulay, Elie |e investigator |4 oth | |
| 700 | 1 | |a Barbier, Francois |e investigator |4 oth | |
| 700 | 1 | |a Bedos, Jean-Pierre |e investigator |4 oth | |
| 700 | 1 | |a Baudry, Thomas |e investigator |4 oth | |
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| 700 | 1 | |a Chemouni, Frank |e investigator |4 oth | |
| 700 | 1 | |a Coupez, Julien Carvelli Elisabeth |e investigator |4 oth | |
| 700 | 1 | |a Darmon, Michael |e investigator |4 oth | |
| 700 | 1 | |a Dupuis, Claire |e investigator |4 oth | |
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