Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study.
<h4>Background</h4>Ventilator-associated pneumonia (VAP) is the most common infection in severely injured patients requiring mechanical ventilation. Chest trauma has been identified as a significant risk factor for VAP. This study aimed to describe the risk factors for early VAP in patie...
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Public Library of Science (PLoS)
2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0324120 |
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| author | Gary Duclos Victor Vidal Noemie Resseguier Mathieu Boutonnet Thomas Botrel Gerard Audibert Manon Séguret Vincent Legros Caroline Jeantrelle Anh Dao Phan Olivier Langeron Elisabeth Gaertner Jean-Luc Hanouz Thomas Clavier Véronique Ramonda Fanny Bounes Paër-Selim Abback Mathieu Willig Julien Pottecher Marc Leone for Traumabase® Group |
| author_facet | Gary Duclos Victor Vidal Noemie Resseguier Mathieu Boutonnet Thomas Botrel Gerard Audibert Manon Séguret Vincent Legros Caroline Jeantrelle Anh Dao Phan Olivier Langeron Elisabeth Gaertner Jean-Luc Hanouz Thomas Clavier Véronique Ramonda Fanny Bounes Paër-Selim Abback Mathieu Willig Julien Pottecher Marc Leone for Traumabase® Group |
| author_sort | Gary Duclos |
| collection | DOAJ |
| description | <h4>Background</h4>Ventilator-associated pneumonia (VAP) is the most common infection in severely injured patients requiring mechanical ventilation. Chest trauma has been identified as a significant risk factor for VAP. This study aimed to describe the risk factors for early VAP in patients with severe blunt thoracic trauma admitted to the intensive care unit (ICU) and receiving mechanical ventilation.<h4>Materials and methods</h4>A retrospective cohort study was conducted using data from a national registry including data from 17 French trauma centers during a period of seven years. The study included patients with severe blunt thoracic trauma requiring invasive mechanical ventilation. Data analysis focused on identifying independent risk factors for early suspected VAP (occurring within 48 hours to 5 days after ICU admission) using two models of logistic regression.<h4>Results</h4>From 31700 patients screened 712 patients were analyzed. Early suspected VAP occurred in 192 (27%) patients. The study identified several independent risk factors associated with early suspected VAP in patients with severe blunt thoracic trauma: male gender (OR= 2.77, 95%CI: 1.68-4.77, p < 0.001), ASA score >1 (OR= 1.64, 95%CI: 1.08-2.50, p = 0.019), injury severity score (ISS) >15 (OR=3.15, 95%CI: 1.13-11.99, p = 0.025), initial Glasgow Coma Scale (GCS) score <9 (OR=2.71, 95%CI: 1.88-3.96, p < 0.001), absolute thoracic abbreviated injury scale (AIS) (OR=1.51, 95%CI: 1.14-1.99, p = 0.003), and the number of packed red blood cells (PRBCs) transfused within the first 24 hours (OR=1.04, 95%CI: 1.00-1.08, p = 0.027). Prehospital antibiotic administration was identified as a protective factor (OR=0.54, 95%CI: 0.29-0.94, p = 0.028).<h4>Conclusion</h4>In patients with severe blunt chest trauma receiving invasive mechanical ventilation, male gender, ASA score, ISS > 15, GCS < 9, thoracic AIS and number of PRBCs transfused were independent risk factors for early suspected VAP. Prehospital antibiotic therapy was a protective factor, suggesting potential strategies for VAP prevention. |
| format | Article |
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| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-5aad0aebacfa407a87555cf37e98913f2025-08-20T03:44:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01205e032412010.1371/journal.pone.0324120Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study.Gary DuclosVictor VidalNoemie ResseguierMathieu BoutonnetThomas BotrelGerard AudibertManon SéguretVincent LegrosCaroline JeantrelleAnh Dao PhanOlivier LangeronElisabeth GaertnerJean-Luc HanouzThomas ClavierVéronique RamondaFanny BounesPaër-Selim AbbackMathieu WilligJulien PottecherMarc Leonefor Traumabase® Group<h4>Background</h4>Ventilator-associated pneumonia (VAP) is the most common infection in severely injured patients requiring mechanical ventilation. Chest trauma has been identified as a significant risk factor for VAP. This study aimed to describe the risk factors for early VAP in patients with severe blunt thoracic trauma admitted to the intensive care unit (ICU) and receiving mechanical ventilation.<h4>Materials and methods</h4>A retrospective cohort study was conducted using data from a national registry including data from 17 French trauma centers during a period of seven years. The study included patients with severe blunt thoracic trauma requiring invasive mechanical ventilation. Data analysis focused on identifying independent risk factors for early suspected VAP (occurring within 48 hours to 5 days after ICU admission) using two models of logistic regression.<h4>Results</h4>From 31700 patients screened 712 patients were analyzed. Early suspected VAP occurred in 192 (27%) patients. The study identified several independent risk factors associated with early suspected VAP in patients with severe blunt thoracic trauma: male gender (OR= 2.77, 95%CI: 1.68-4.77, p < 0.001), ASA score >1 (OR= 1.64, 95%CI: 1.08-2.50, p = 0.019), injury severity score (ISS) >15 (OR=3.15, 95%CI: 1.13-11.99, p = 0.025), initial Glasgow Coma Scale (GCS) score <9 (OR=2.71, 95%CI: 1.88-3.96, p < 0.001), absolute thoracic abbreviated injury scale (AIS) (OR=1.51, 95%CI: 1.14-1.99, p = 0.003), and the number of packed red blood cells (PRBCs) transfused within the first 24 hours (OR=1.04, 95%CI: 1.00-1.08, p = 0.027). Prehospital antibiotic administration was identified as a protective factor (OR=0.54, 95%CI: 0.29-0.94, p = 0.028).<h4>Conclusion</h4>In patients with severe blunt chest trauma receiving invasive mechanical ventilation, male gender, ASA score, ISS > 15, GCS < 9, thoracic AIS and number of PRBCs transfused were independent risk factors for early suspected VAP. Prehospital antibiotic therapy was a protective factor, suggesting potential strategies for VAP prevention.https://doi.org/10.1371/journal.pone.0324120 |
| spellingShingle | Gary Duclos Victor Vidal Noemie Resseguier Mathieu Boutonnet Thomas Botrel Gerard Audibert Manon Séguret Vincent Legros Caroline Jeantrelle Anh Dao Phan Olivier Langeron Elisabeth Gaertner Jean-Luc Hanouz Thomas Clavier Véronique Ramonda Fanny Bounes Paër-Selim Abback Mathieu Willig Julien Pottecher Marc Leone for Traumabase® Group Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study. PLoS ONE |
| title | Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study. |
| title_full | Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study. |
| title_fullStr | Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study. |
| title_full_unstemmed | Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study. |
| title_short | Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study. |
| title_sort | risk factors for early suspected ventilator associated pneumonia in severe thoracic blunt trauma patient a french national cohort study |
| url | https://doi.org/10.1371/journal.pone.0324120 |
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