Research Article
Construction and Validation of a Predictive Model for the Risk of Ventilator-Associated Pneumonia in Elderly ICU Patients
Table 1
Univariate analysis of VAP risk in elderly ICU patients on MV (n = 1219, n (%)).
| | | VAP (%) | Total (%) | | | | Yes | No |
| | Gender | Male | 91 (66.4) | 712 (65.8) | 803 (65.9) | 0.021 | 0.885 | | Female | 46 (33.6) | 370 (34.2) | 416 (34.1) |
| | Length of ICU stay | 0–19 | 44 (32.1) | 589 (54.4) | 633 (51.9) | 24.267 | <0.001 | | >19 | 93 (67.9) | 493 (45.6) | 586 (8.1) |
| | Fever | Yes | 103 (75.2) | 618 (57.1) | 721 (59.1) | 16.425 | <0.001 | | No | 34 (24.8) | 464 (42.9) | 498 (40.9) | | |
| | Days with fever | 0–2 | 45 (32.8) | 584 (54.0) | 629 (51.6) | 21.734 | <0.001 | | >2 | 92 (67.2) | 498 (46.0) | 590 (48.4) | | |
| | Smoking | Yes | 65 (47.4) | 440 (40.7) | 505 (41.4) | 2.304 | 0.141 | | No | 72 (52.6) | 642 (59.3) | 714 (58.6) | | |
| | Alcohol consumption | Yes | 42 (47.4) | 383 (40.7) | 505 (41.4) | 1.203 | 0.296 | | No | 95 (52.6) | 699 (59.3) | 714 (58.6) | | |
| | Admission department | Emergency | 8 (5.8) | 54 (5.0) | 62 (5.1) | 0.904 | 0.636 | | Surgical | 67 (48.9) | 493 (45.6) | 560 (45.9) | | Medical | 62 (45.3) | 535 (49.4) | 597 (49.0) |
| | Underlying diseases | COPD | 2 (1.5) | 242 (22.4) | 244 (20.0) | 33.197 | <0.001 | | Heart failure | 13 (9.5) | 112 (10.4) | 125 (10.3) | 0.098 | 0.881 | | Chronic renal failure | 5 (3.6) | 25 (2.3) | 30 (2.5) | 0.908 | 0.372 | | Diabetes mellitus | 17 (12.4) | 158 (14.6) | 175 (14.4) | 0.476 | 0.605 | | Cancer | 14 (10.2) | 135 (12.5) | 149 (12.2) | 0.578 | 0.579 | | Immune suppression | 15 (10.9) | 126 (11.6) | 141 (11.6) | 0.058 | 0.888 |
| | Reason of admission | Respiratory | 51 (37.2) | 455 (42.1) | 506 (41.5) | 1.130 | 0.288 | | Cardiovascular | 9 (6.6) | 79 (7.3) | 88 (7.2) | 0.097 | 0.755 | | Digestive | 8 (5.8) | 48 (4.4) | 56 (4.6) | 0.546 | 0.460 | | Trauma | 32 (23.4) | 309 (28.6) | 341 (28.0) | 1.632 | 0.201 | | Severe sepsis | 18 (13.1) | 114 (10.5) | 132 (10.8) | 0.853 | 0.356 | | Other | 23 (16.8) | 137 (12.7) | 160 (13.1) | 1.816 | 0.178 |
| | VAP prevention | Bed head elevation > 30° | 124 (90.5) | 952 (88.0) | 1076 (88.3) | 0.749 | 0.387 | | Daily wake up | 94 (68.6) | 757 (70.0) | 851 (69.8) | 0.105 | 0.746 | | DVT prevention | 107 (78.1) | 865 (79.9) | 972 (79.7) | 0.255 | 0.613 | | Oral care with chlorhexidine | 105 (76.6) | 806 (74.5) | 911 (74.7) | 0.298 | 0.585 | | Tube cuff pressure monitoring >4 times per day | 89 (65.0) | 687 (63.5) | 776 (63.7) | 0.114 | 0.736 | | Subglottic drainage | 27 (19.7) | 194 (17.9) | 221 (18.1) | 0.259 | 0.611 |
| | Materials of tube | Polyvinylchloride | 132 (96.4) | 1062 (98.2) | 1194 (98.0) | 1.964 | 0.189 | | Polyurethane | 5 (3.6) | 20 (1.8) | 25 (2.0) |
| | Surgery | Yes | 87 (63.5) | 141 (13.0) | 228 (18.7) | 203.727 | <0.001 | | No | 50 (36.5) | 941 (87.0) | 991 (81.3) |
| | Number of surgeries | 0–2 | 127 (92.7) | 1060 (98.0) | 1187 (97.4) | — | 0.002 | | >2 | 10 (7.3) | 22 (2.0) | 32 (2.6) |
| | Antibiotics use after surgery | Yes | 132 (96.4) | 1047 (96.8) | 1179 (96.7) | 0.066 | 0.797 | | No | 5 (3.6) | 35 (3.2) | 40 (3.3) |
| | Duration of antibiotics use after surgery | 0–14 | 71 (51.8) | 568 (52.5) | 639 (52.4) | 0.022 | 0.882 | | >14 | 66 (48.2) | 514 (47.5) | 580 (47.6) |
| | Combined application of antibiotics | Yes | 115 (83.9) | 930 (86.0) | 1045 (85.7) | 0.402 | 0.526 | | No | 22 (16.1) | 152 (14.0) | 174 (14.3) |
| | CRP (mg/L) | >8 | 78 (56.9) | 346 (32.0) | 424 (34.8) | 33.388 | <0.001 | | 0–8 | 59 (43.1) | 736 (68.0) | 795 (65.2) |
| | PCT (ng/mL) | >0.25 | 33 (24.1) | 357 (33.0) | 390 (32.0) | 4.434 | 0.035 | | 0–0.25 | 104 (75.9) | 725 (67.0) | 829 (68.0) |
| | Urinary WBC count | Abnormal | 33 (24.1) | 373 (34.5) | 406 (33.3) | 5.905 | 0.015 | | Normal | 401 (75.9) | 709 (65.5) | 813 (66.7) |
| | Duration days of CVC | 0–7 | 34 (24.9) | 591 (54.6) | 625 (51.3) | 42.234 | <0.001 | | >7 | 103 (75.2) | 491 (45.4) | 594 (48.7) |
| | Indwelling CVC | Yes | 122 (89.1) | 629 (58.1) | 751 (61.6) | 49.146 | 0.035 | | No | 15 (10.9) | 453 (41.9) | 468 (38.4) |
| | Number of indwelling CVC | 0–2 | 128 (93.4) | 1055 (97.5) | 1183 (97.0) | 5.905 | 0.015 | | >2 | 9 (6.6) | 27 (2.5) | 36 (3.0) |
| | Duration days of urinary catheter | 0–10 | 65 (47.4) | 559 (51.7) | 624 (51.2) | 0.866 | 0.352 | | >10 | 72 (52.6) | 523 (48.3) | 595 (48.8) |
| | Indwelling urinary catheter | Yes | 121 (88.3) | 751 (69.4) | 872 (71.5) | 21.360 | <0.001 | | No | 16 (11.7) | 331 (30.6) | 347 (28.5) |
| | Number of indwelling urinary catheter | 0–2 | 115 (83.9) | 970 (89.6) | 1085 (89.0) | 5.905 | 0.015 | | >2 | 22 (16.1) | 112 (10.4) | 134 (11.0) |
| | Duration days of MV | 0–10 | 72 (52.6) | 561 (51.8) | 633 (51.9) | 0.024 | 0.876 | | >10 | 65 (47.4) | 521 (48.2) | 586 (48.1) |
| | Number of reintubations | 0–2 | 123 (89.8) | 1027 (94.9) | 1150 (94.3) | 6.006 | 0.014 | | >2 | 14 (10.2) | 55 (5.1) | 69 (5.7) |
| | Total | 137 (11.2) | 1082 (88.8) | 1219 (100.0) | | | |
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Fisher’s exact probability method. VAP, ventilator-associated pneumonia; ICU, intensive-care unit; MV, mechanical ventilation; COPD, chronic obstructive pulmonary disease; DVT, deep venous thrombi; CRP, C-reactive protein; PCT, procalcitonin; WBC, white blood cell; CVC, central-venous catheter. Normal WBC counts in urine are 1–10 in males and 0–5 in females. |
