Race and gender may predict VAP risk

Key clinical point: Epidemiologic factors linked to increased risk of ventilator-associated pneumonia should increase clinical suspicion of VAP.

Major finding: Black race, male gender, and teaching hospital setting predicted VAP (odds ratios, 1.23, 1.33, and 1.64, respectively).

Data source: An analysis of data from 905,000 patients in the Nationwide Inpatient Sample.

Disclosures: Dr. Mehta reported having no disclosures.




AUSTIN, TEX. – Race, gender, and care setting appear to predict ventilator-associated pneumonia, according to an analysis of data from the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample.

The strongest predictor of ventilator-associated pneumonia (VAP) was mechanical ventilation for more than 96 hours (odds ratio, 13.64) in an analysis of 13,082 patients who developed the condition. The study subjects were among the 905,000 patients who required mechanical ventilation between 2008 and 2011 and who were available for analysis. The study was controlled for known VAP risk factors, including age, chronic lung disease, altered level of consciousness, acute respiratory distress syndrome, nasogastric tube, aspiration, comorbid conditions, chest surgery, hospital characteristics, and insurance status, Dr. Kathan Mehta of the University of Pittsburgh Medical Center, reported at the annual meeting of the American College of Chest Physicians.

Black patients, men, and those who were treated at a teaching hospital were also at significantly increased risk for VAP (OR, 1.23, 1.33, and 1.64, respectively), Dr. Mehta said.

VAP is an important cause of morbidity and mortality in hospitalized patients requiring mechanical ventilation. A number of risk factors have been associated with high incidence of VAP, but the role of epidemiologic factors in VAP development has been largely unknown, he said.

The current findings – from the one of the largest available comprehensive hospital discharge datasets on mechanical ventilation – have implications for preventing VAP and for improving the diagnosis and treatment of VAP. The at-risk population may benefit from higher suspicion for VAP for early diagnosis and treatment, and from aggressive measures to prevent VAP,” he said. Dr. Mehta reported having no disclosures.

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