Ventilator-associated pneumonia: caveats for benchmarking

Philippe Eggimann1, Stéphane Hugonnet, Hugo Sax

  • 1Infection Control Program, Department of Internal Medicine, University Hospitals of Geneva, 1211, Geneva 14, Switzerland.

Intensive Care Medicine
|September 5, 2003
PubMed
Abstract

Insights

Reporting ventilator-associated pneumonia (VAP) rates using different denominators significantly impacts risk estimates. Understanding these variations is crucial for accurate comparison of hospital-acquired infection rates.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • Ventilator-associated pneumonia (VAP) is a significant hospital-acquired infection in intensive care units (ICUs).
  • Accurate risk estimation is vital for effective infection control strategies.
  • Standardized reporting methods for VAP are essential for reliable comparisons.

Purpose of the Study:

  • To evaluate the impact of various denominators on the calculated risk estimates for VAP.
  • To compare VAP incidence rates reported per patient-day, patient-day at risk, ventilator-day, and ventilator-day at risk.

Main Methods:

  • Prospective cohort study conducted in a medical ICU of a large teaching hospital.
  • Inclusion of consecutive patients admitted for over 48 hours between October 1995 and November 1997.
  • Recording of ICU-acquired infections using modified CDC criteria and calculation of VAP rates using multiple denominators.

Main Results:

  • VAP developed in 106 (23.5%) of 1,068 mechanically ventilated patients.
  • Incidence rates varied significantly based on the denominator used, ranging from 22.8 to 44.0 per 1,000 units.
  • Reporting VAP per 1,000 ventilator-days at risk yielded the highest incidence rate.

Conclusions:

  • The choice of denominator substantially influences VAP risk estimates.
  • Clinicians and hospital administrators must be aware of these reporting differences to interpret and compare infection rates accurately.
  • Standardized reporting practices are recommended to ensure consistency in VAP surveillance.

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