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Incidence, Risk Factors, and Outcomes of Ventilator-Associated Pneumonia Traumatic Brain Injury: A Meta-analysis

  • Yating Li
  • Chenxia Liu
  • Wei Xiao
  • Tiantian Song
  • Shuhui WangEmail author
Review

Abstract

Ventilator-associated pneumonia (VAP) is one of the most severe complications in patients with traumatic brain injury (TBI) and is considered a risk factor for poor outcomes. However, the incidence of VAP among patients with TBI reported in studies varies widely. What is more, the risk factors and outcomes of VAP are controversial. This study estimates the incidence, risk factors, and outcomes of VAP in patients with TBI and provides evidence for prevention and treatment. PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched from the earliest records to May 2018. Data involving the incidence, risk factors, and outcomes were extracted for meta-analysis. The results showed that the incidence of VAP was 36% (95% confidence interval (CI) 31–41%); risk factors analyses showed that smoking [odds ratio (OR) 2.13; 95% CI 1.16–3.92], tracheostomy (OR 9.55; 95% CI 3.24–28.17), blood transfusion on admission (OR 2.54; 95% CI 1.24–5.18), barbiturate infusion (OR 3.52; 95% CI 1.68–7.40), injury severity score (OR 4.65; 95% CI 1.96–7.34), and head abbreviated injury scale (OR 2.99; 95% CI 1.66–5.37) were related to the occurrence of VAP. When patients developed VAP, mechanical ventilation time (OR 5.45; 95% CI 3.78–7.12), ICU length of stay (OR 6.85; 95% CI 4.90–8.79), and hospital length of stay (OR 10.92; 95% CI 9.12–12.72) were significantly increased. However, VAP was not associated with an increased risk of mortality (OR 1.28; 95% CI 0.74–2.21). VAP is common in patients with TBI. It is affected by a series of factors and has a poor prognosis.

Keywords

Ventilator-associated pneumonia Traumatic brain injury Incidence Risk factors Outcome 

Notes

Author contributions

YTL was responsible for study design, literature search, data extraction, data analysis, and manuscript drafting. CXL was responsible for literature search, data extraction, and manuscript drafting. WX was responsible for data analysis and manuscript drafting. TTS was responsible for manuscript drafting and manuscript revision. SHW was responsible for study design, study supervision, and manuscript revision.

Source of support

This study was funded by the Natural Science Foundation of Shandong Province (Grant No. ZR2018 MG015).

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Supplementary material

12028_2019_773_MOESM1_ESM.doc (28 kb)
Supplementary material 1 (DOC 27 kb)
12028_2019_773_MOESM2_ESM.doc (61 kb)
Supplementary material 2 (DOC 61 kb)
12028_2019_773_MOESM3_ESM.doc (156 kb)
Supplementary material 3 (DOC 156 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019

Authors and Affiliations

  • Yating Li
    • 1
    • 2
  • Chenxia Liu
    • 1
    • 2
  • Wei Xiao
    • 3
  • Tiantian Song
    • 1
    • 2
  • Shuhui Wang
    • 1
    Email author
  1. 1.Department of Infection Prevention and ControlQilu Hospital of Shandong UniversityJinanChina
  2. 2.School of NursingShandong UniversityJinanChina
  3. 3.Jinan Central Hospital Affiliated to Shandong UniversityJinanChina

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