Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19
Patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at higher risk of ventilator-associated pneumonia (VAP) and may have an increased attributable mortality (increased or decreased risk of death if VAP occurs in a patient) and attributable fraction (proportion...
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| Veröffentlicht in: | American journal of respiratory and critical care medicine 2022-07, Vol.206 (2), p.161-169 |
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| creator | Vacheron, Charles-Hervé Lepape, Alain Savey, Anne Machut, Anaïs Timsit, Jean Francois Comparot, Sylvie Courno, Gaelle Vanhems, Philippe Landel, Verena Lavigne, Thierry Bailly, Sebastien Bettega, Francois Maucort-Boulch, Delphine Friggeri, Arnaud |
| description | Patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at higher risk of ventilator-associated pneumonia (VAP) and may have an increased attributable mortality (increased or decreased risk of death if VAP occurs in a patient) and attributable fraction (proportion of deaths that are attributable to an exposure) of VAP-related mortality compared with subjects without coronavirus disease (COVID-19).
Estimation of the attributable mortality of the VAP among patients with COVID-19.
Using the REA-REZO surveillance network, three groups of adult medical ICU patients were computed: control group (patients admitted between 2016 and 2019; prepandemic patients), pandemic COVID-19 group (PandeCOV
), and pandemic non-COVID-19 group (PandeCOV
) admitted during 2020. The primary outcome was the estimation of attributable mortality and attributable fraction related to VAP in these patients. Using multistate modeling with causal inference, the outcomes related to VAP were also evaluated.
A total of 64,816 patients were included in the control group, 7,442 in the PandeCOV
group, and 1,687 in the PandeCOV
group. The incidence of VAP was 14.2 (95% confidence interval [CI], 13.9 to 14.6), 18.3 (95% CI, 17.3 to 19.4), and 31.9 (95% CI, 29.8 to 34.2) per 1,000 ventilation-days in each group, respectively. Attributable mortality at 90 days was 3.15% (95%, CI, 2.04% to 3.43%), 2.91% (95% CI, -0.21% to 5.02%), and 8.13% (95% CI, 3.54% to 12.24%), and attributable fraction of mortality at 90 days was 1.22% (95% CI, 0.83 to 1.63), 1.42% (95% CI, -0.11% to 2.61%), and 9.17% (95% CI, 3.54% to 12.24%) for the control, PandeCOV
, and PandeCOV
groups, respectively. Except for the higher risk of developing VAP, the PandeCOV
group shared similar VAP characteristics with the control group. PandeCOV
patients were at lower risk of death without VAP (hazard ratio, 0.62; 95% CI, 0.52 to 0.74) than the control group.
VAP-attributable mortality was higher for patients with COVID-19, with more than 9% of the overall mortality related to VAP. |
| doi_str_mv | 10.1164/rccm.202202-0357OC |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9887408</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2691096307</sourcerecordid><originalsourceid>FETCH-LOGICAL-c467t-e7399a851ac2bcebd5a096a25dc7ced2c4a81d8aac4f2b5c02d6adede68bf63f3</originalsourceid><addsrcrecordid>eNpdkV9rFDEUxYMotq5-AR9kwBcfOjV_Z5IXYVmrLaxsH3TxLdxJMt2UmUlNMpV-e1OmFi0EbiDnnHtvfgi9JfiUkIZ_jMaMpxTTcmrMRLvbPEPHRDBRc9Xi5-WOW1Zzrn4eoVcpXWNMqCT4JTpiQrCWUHqM9uuco-_mDN3gqm8hZhh8vqtCX-3dlP0AOcQaUgrGQ3a2upzcPIbJQ7Uu5aq6hOyLMFW_fT5Um93-4nNN1Gv0oochuTcPdYV-fDn7vjmvt7uvF5v1tja8aXPtWqYUSEHA0M64zgrAqgEqrGmNs9RwkMRKAMN72gmDqW3AOusa2fUN69kKfVpyb-ZudNaUSSIM-ib6EeKdDuD1_y-TP-ircKuVlC3HsgScLAGHJ7bz9Vb7Kbk4asyU4FiJW1LkHx76xfBrdinr0SfjhgEmF-akadNQwYWSqkjfP5FehzlO5TeKSpGyJyt4VoguKhNDStH1j0MQrO8p63vKeqGsF8rF9O7frR8tf7GyP0w-paI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2691096307</pqid></control><display><type>article</type><title>Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19</title><source>MEDLINE</source><source>Free E-Journal (出版社公開部分のみ）</source><source>American Thoracic Society Journals</source><source>Alma/SFX Local Collection</source><creator>Vacheron, Charles-Hervé ; Lepape, Alain ; Savey, Anne ; Machut, Anaïs ; Timsit, Jean Francois ; Comparot, Sylvie ; Courno, Gaelle ; Vanhems, Philippe ; Landel, Verena ; Lavigne, Thierry ; Bailly, Sebastien ; Bettega, Francois ; Maucort-Boulch, Delphine ; Friggeri, Arnaud</creator><creatorcontrib>Vacheron, Charles-Hervé ; Lepape, Alain ; Savey, Anne ; Machut, Anaïs ; Timsit, Jean Francois ; Comparot, Sylvie ; Courno, Gaelle ; Vanhems, Philippe ; Landel, Verena ; Lavigne, Thierry ; Bailly, Sebastien ; Bettega, Francois ; Maucort-Boulch, Delphine ; Friggeri, Arnaud ; REA-REZO Study Group ; the REA-REZO Study Group</creatorcontrib><description>Patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at higher risk of ventilator-associated pneumonia (VAP) and may have an increased attributable mortality (increased or decreased risk of death if VAP occurs in a patient) and attributable fraction (proportion of deaths that are attributable to an exposure) of VAP-related mortality compared with subjects without coronavirus disease (COVID-19).
Estimation of the attributable mortality of the VAP among patients with COVID-19.
Using the REA-REZO surveillance network, three groups of adult medical ICU patients were computed: control group (patients admitted between 2016 and 2019; prepandemic patients), pandemic COVID-19 group (PandeCOV
), and pandemic non-COVID-19 group (PandeCOV
) admitted during 2020. The primary outcome was the estimation of attributable mortality and attributable fraction related to VAP in these patients. Using multistate modeling with causal inference, the outcomes related to VAP were also evaluated.
A total of 64,816 patients were included in the control group, 7,442 in the PandeCOV
group, and 1,687 in the PandeCOV
group. The incidence of VAP was 14.2 (95% confidence interval [CI], 13.9 to 14.6), 18.3 (95% CI, 17.3 to 19.4), and 31.9 (95% CI, 29.8 to 34.2) per 1,000 ventilation-days in each group, respectively. Attributable mortality at 90 days was 3.15% (95%, CI, 2.04% to 3.43%), 2.91% (95% CI, -0.21% to 5.02%), and 8.13% (95% CI, 3.54% to 12.24%), and attributable fraction of mortality at 90 days was 1.22% (95% CI, 0.83 to 1.63), 1.42% (95% CI, -0.11% to 2.61%), and 9.17% (95% CI, 3.54% to 12.24%) for the control, PandeCOV
, and PandeCOV
groups, respectively. Except for the higher risk of developing VAP, the PandeCOV
group shared similar VAP characteristics with the control group. PandeCOV
patients were at lower risk of death without VAP (hazard ratio, 0.62; 95% CI, 0.52 to 0.74) than the control group.
VAP-attributable mortality was higher for patients with COVID-19, with more than 9% of the overall mortality related to VAP.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.202202-0357OC</identifier><identifier>PMID: 35537122</identifier><language>eng</language><publisher>United States: American Thoracic Society</publisher><subject>Adult ; Clinical outcomes ; COVID-19 ; Hospital Mortality ; Humans ; Intensive Care Units ; Life Sciences ; Medical research ; Mortality ; Original ; Pneumonia ; Pneumonia, Ventilator-Associated - epidemiology ; SARS-CoV-2</subject><ispartof>American journal of respiratory and critical care medicine, 2022-07, Vol.206 (2), p.161-169</ispartof><rights>Copyright American Thoracic Society Jul 15, 2022</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>Copyright © 2022 by the American Thoracic Society 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-e7399a851ac2bcebd5a096a25dc7ced2c4a81d8aac4f2b5c02d6adede68bf63f3</citedby><cites>FETCH-LOGICAL-c467t-e7399a851ac2bcebd5a096a25dc7ced2c4a81d8aac4f2b5c02d6adede68bf63f3</cites><orcidid>0000-0002-2179-4650 ; 0000-0003-1575-5847 ; 0000-0003-0042-7787 ; 0000-0003-3188-1456</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,4010,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35537122$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-03954095$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Vacheron, Charles-Hervé</creatorcontrib><creatorcontrib>Lepape, Alain</creatorcontrib><creatorcontrib>Savey, Anne</creatorcontrib><creatorcontrib>Machut, Anaïs</creatorcontrib><creatorcontrib>Timsit, Jean Francois</creatorcontrib><creatorcontrib>Comparot, Sylvie</creatorcontrib><creatorcontrib>Courno, Gaelle</creatorcontrib><creatorcontrib>Vanhems, Philippe</creatorcontrib><creatorcontrib>Landel, Verena</creatorcontrib><creatorcontrib>Lavigne, Thierry</creatorcontrib><creatorcontrib>Bailly, Sebastien</creatorcontrib><creatorcontrib>Bettega, Francois</creatorcontrib><creatorcontrib>Maucort-Boulch, Delphine</creatorcontrib><creatorcontrib>Friggeri, Arnaud</creatorcontrib><creatorcontrib>REA-REZO Study Group</creatorcontrib><creatorcontrib>the REA-REZO Study Group</creatorcontrib><title>Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>Patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at higher risk of ventilator-associated pneumonia (VAP) and may have an increased attributable mortality (increased or decreased risk of death if VAP occurs in a patient) and attributable fraction (proportion of deaths that are attributable to an exposure) of VAP-related mortality compared with subjects without coronavirus disease (COVID-19).
Estimation of the attributable mortality of the VAP among patients with COVID-19.
Using the REA-REZO surveillance network, three groups of adult medical ICU patients were computed: control group (patients admitted between 2016 and 2019; prepandemic patients), pandemic COVID-19 group (PandeCOV
), and pandemic non-COVID-19 group (PandeCOV
) admitted during 2020. The primary outcome was the estimation of attributable mortality and attributable fraction related to VAP in these patients. Using multistate modeling with causal inference, the outcomes related to VAP were also evaluated.
A total of 64,816 patients were included in the control group, 7,442 in the PandeCOV
group, and 1,687 in the PandeCOV
group. The incidence of VAP was 14.2 (95% confidence interval [CI], 13.9 to 14.6), 18.3 (95% CI, 17.3 to 19.4), and 31.9 (95% CI, 29.8 to 34.2) per 1,000 ventilation-days in each group, respectively. Attributable mortality at 90 days was 3.15% (95%, CI, 2.04% to 3.43%), 2.91% (95% CI, -0.21% to 5.02%), and 8.13% (95% CI, 3.54% to 12.24%), and attributable fraction of mortality at 90 days was 1.22% (95% CI, 0.83 to 1.63), 1.42% (95% CI, -0.11% to 2.61%), and 9.17% (95% CI, 3.54% to 12.24%) for the control, PandeCOV
, and PandeCOV
groups, respectively. Except for the higher risk of developing VAP, the PandeCOV
group shared similar VAP characteristics with the control group. PandeCOV
patients were at lower risk of death without VAP (hazard ratio, 0.62; 95% CI, 0.52 to 0.74) than the control group.
VAP-attributable mortality was higher for patients with COVID-19, with more than 9% of the overall mortality related to VAP.</description><subject>Adult</subject><subject>Clinical outcomes</subject><subject>COVID-19</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Life Sciences</subject><subject>Medical research</subject><subject>Mortality</subject><subject>Original</subject><subject>Pneumonia</subject><subject>Pneumonia, Ventilator-Associated - epidemiology</subject><subject>SARS-CoV-2</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV9rFDEUxYMotq5-AR9kwBcfOjV_Z5IXYVmrLaxsH3TxLdxJMt2UmUlNMpV-e1OmFi0EbiDnnHtvfgi9JfiUkIZ_jMaMpxTTcmrMRLvbPEPHRDBRc9Xi5-WOW1Zzrn4eoVcpXWNMqCT4JTpiQrCWUHqM9uuco-_mDN3gqm8hZhh8vqtCX-3dlP0AOcQaUgrGQ3a2upzcPIbJQ7Uu5aq6hOyLMFW_fT5Um93-4nNN1Gv0oochuTcPdYV-fDn7vjmvt7uvF5v1tja8aXPtWqYUSEHA0M64zgrAqgEqrGmNs9RwkMRKAMN72gmDqW3AOusa2fUN69kKfVpyb-ZudNaUSSIM-ib6EeKdDuD1_y-TP-ircKuVlC3HsgScLAGHJ7bz9Vb7Kbk4asyU4FiJW1LkHx76xfBrdinr0SfjhgEmF-akadNQwYWSqkjfP5FehzlO5TeKSpGyJyt4VoguKhNDStH1j0MQrO8p63vKeqGsF8rF9O7frR8tf7GyP0w-paI</recordid><startdate>20220715</startdate><enddate>20220715</enddate><creator>Vacheron, Charles-Hervé</creator><creator>Lepape, Alain</creator><creator>Savey, Anne</creator><creator>Machut, Anaïs</creator><creator>Timsit, Jean Francois</creator><creator>Comparot, Sylvie</creator><creator>Courno, Gaelle</creator><creator>Vanhems, Philippe</creator><creator>Landel, Verena</creator><creator>Lavigne, Thierry</creator><creator>Bailly, Sebastien</creator><creator>Bettega, Francois</creator><creator>Maucort-Boulch, Delphine</creator><creator>Friggeri, Arnaud</creator><general>American Thoracic Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2179-4650</orcidid><orcidid>https://orcid.org/0000-0003-1575-5847</orcidid><orcidid>https://orcid.org/0000-0003-0042-7787</orcidid><orcidid>https://orcid.org/0000-0003-3188-1456</orcidid></search><sort><creationdate>20220715</creationdate><title>Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19</title><author>Vacheron, Charles-Hervé ; Lepape, Alain ; Savey, Anne ; Machut, Anaïs ; Timsit, Jean Francois ; Comparot, Sylvie ; Courno, Gaelle ; Vanhems, Philippe ; Landel, Verena ; Lavigne, Thierry ; Bailly, Sebastien ; Bettega, Francois ; Maucort-Boulch, Delphine ; Friggeri, Arnaud</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-e7399a851ac2bcebd5a096a25dc7ced2c4a81d8aac4f2b5c02d6adede68bf63f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Clinical outcomes</topic><topic>COVID-19</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Life Sciences</topic><topic>Medical research</topic><topic>Mortality</topic><topic>Original</topic><topic>Pneumonia</topic><topic>Pneumonia, Ventilator-Associated - epidemiology</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vacheron, Charles-Hervé</creatorcontrib><creatorcontrib>Lepape, Alain</creatorcontrib><creatorcontrib>Savey, Anne</creatorcontrib><creatorcontrib>Machut, Anaïs</creatorcontrib><creatorcontrib>Timsit, Jean Francois</creatorcontrib><creatorcontrib>Comparot, Sylvie</creatorcontrib><creatorcontrib>Courno, Gaelle</creatorcontrib><creatorcontrib>Vanhems, Philippe</creatorcontrib><creatorcontrib>Landel, Verena</creatorcontrib><creatorcontrib>Lavigne, Thierry</creatorcontrib><creatorcontrib>Bailly, Sebastien</creatorcontrib><creatorcontrib>Bettega, Francois</creatorcontrib><creatorcontrib>Maucort-Boulch, Delphine</creatorcontrib><creatorcontrib>Friggeri, Arnaud</creatorcontrib><creatorcontrib>REA-REZO Study Group</creatorcontrib><creatorcontrib>the REA-REZO Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vacheron, Charles-Hervé</au><au>Lepape, Alain</au><au>Savey, Anne</au><au>Machut, Anaïs</au><au>Timsit, Jean Francois</au><au>Comparot, Sylvie</au><au>Courno, Gaelle</au><au>Vanhems, Philippe</au><au>Landel, Verena</au><au>Lavigne, Thierry</au><au>Bailly, Sebastien</au><au>Bettega, Francois</au><au>Maucort-Boulch, Delphine</au><au>Friggeri, Arnaud</au><aucorp>REA-REZO Study Group</aucorp><aucorp>the REA-REZO Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2022-07-15</date><risdate>2022</risdate><volume>206</volume><issue>2</issue><spage>161</spage><epage>169</epage><pages>161-169</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>Patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are at higher risk of ventilator-associated pneumonia (VAP) and may have an increased attributable mortality (increased or decreased risk of death if VAP occurs in a patient) and attributable fraction (proportion of deaths that are attributable to an exposure) of VAP-related mortality compared with subjects without coronavirus disease (COVID-19).
Estimation of the attributable mortality of the VAP among patients with COVID-19.
Using the REA-REZO surveillance network, three groups of adult medical ICU patients were computed: control group (patients admitted between 2016 and 2019; prepandemic patients), pandemic COVID-19 group (PandeCOV
), and pandemic non-COVID-19 group (PandeCOV
) admitted during 2020. The primary outcome was the estimation of attributable mortality and attributable fraction related to VAP in these patients. Using multistate modeling with causal inference, the outcomes related to VAP were also evaluated.
A total of 64,816 patients were included in the control group, 7,442 in the PandeCOV
group, and 1,687 in the PandeCOV
group. The incidence of VAP was 14.2 (95% confidence interval [CI], 13.9 to 14.6), 18.3 (95% CI, 17.3 to 19.4), and 31.9 (95% CI, 29.8 to 34.2) per 1,000 ventilation-days in each group, respectively. Attributable mortality at 90 days was 3.15% (95%, CI, 2.04% to 3.43%), 2.91% (95% CI, -0.21% to 5.02%), and 8.13% (95% CI, 3.54% to 12.24%), and attributable fraction of mortality at 90 days was 1.22% (95% CI, 0.83 to 1.63), 1.42% (95% CI, -0.11% to 2.61%), and 9.17% (95% CI, 3.54% to 12.24%) for the control, PandeCOV
, and PandeCOV
groups, respectively. Except for the higher risk of developing VAP, the PandeCOV
group shared similar VAP characteristics with the control group. PandeCOV
patients were at lower risk of death without VAP (hazard ratio, 0.62; 95% CI, 0.52 to 0.74) than the control group.
VAP-attributable mortality was higher for patients with COVID-19, with more than 9% of the overall mortality related to VAP.</abstract><cop>United States</cop><pub>American Thoracic Society</pub><pmid>35537122</pmid><doi>10.1164/rccm.202202-0357OC</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2179-4650</orcidid><orcidid>https://orcid.org/0000-0003-1575-5847</orcidid><orcidid>https://orcid.org/0000-0003-0042-7787</orcidid><orcidid>https://orcid.org/0000-0003-3188-1456</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1073-449X |
| ispartof | American journal of respiratory and critical care medicine, 2022-07, Vol.206 (2), p.161-169 |
| issn | 1073-449X 1535-4970 |
| language | eng |
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| source | MEDLINE; Free E-Journal (出版社公開部分のみ）; American Thoracic Society Journals; Alma/SFX Local Collection |
| subjects | Adult Clinical outcomes COVID-19 Hospital Mortality Humans Intensive Care Units Life Sciences Medical research Mortality Original Pneumonia Pneumonia, Ventilator-Associated - epidemiology SARS-CoV-2 |
| title | Attributable Mortality of Ventilator-associated Pneumonia Among Patients with COVID-19 |
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