Abstract:
Background:In 2013, the Centers for Disease Control and Prevention (CDC) issued the concept of the ventilator-associated events (VAEs) as a quality indicator (QI) in the intensive care unit (ICU). A number of studies have been conducted in the United States and other Western countries to evaluate its practicality. However, information on VAEs in non-Western countries is scarce. The purpose of this preliminary study was to illuminate the incidence and associated mortality rate of VAEs in Japan, as a first step in the effort to determine its practicality. Methods:We conducted a multi-center, retrospective review of patient medical record using VAEs surveillance algorithm. We analyzed 785 patients with ≥2 days of mechanical ventilator (MV), admitted to the ICU at seven urban hospital in Japan. The prevalence of VAEs, including its three subtypes, and in-ICU mortality were researched. Results:Forty-nine VAEs were identified, affecting 5.7% of patients requiring MV for ≥2 days and 6.4 per 1,000 MV days. Mortality in those who developed VAEs was 42.9%, significantly higher than the rest of the cohort (vs. 15.4%, P<0.001). The overall equivalent distribution of the three VAEs subtype incidences was evaluated: the incidences of VAC only, IVAC only and PVAP were 2.20, 1.90 and 2.29 per 1,000 MV days respectively (P=0.933). However, VAE etiology and mortality was facility dependent. ICUs with a large proportion of surgical patients and more severe cases tended to have increased VAE incidence, with a converse decrease in closed ICUs. Conclusions:The prevalence of VAEs appears low in Japanese ICUs. Nonetheless, mortality was substantially higher in patients who developed VAEs. Although some potential indices of VAEs are suggested to serve as QIs, additional studies to elaborate its practicality would further be required.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Nakahashi S,Imai H,Imanaka H,Ohshimo S,Satou T,Shima M,Yanagisawa M,Yamashita C,Ogura T,Yamada T,Shime Ndoi
10.21037/jtd.2018.12.40subject
Has Abstractpub_date
2018-12-01 00:00:00pages
6942-6949issue
12eissn
2072-1439issn
2077-6624pii
jtd-10-12-6942journal_volume
10pub_type
杂志文章abstract::In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure...
journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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pub_type: 评论,杂志文章
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