391. Mortality in Patients with Ventilator-Associated Pneumonia and Severe Sepsis is Determined by the Number of Organ Failures
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Ventilator-Associated Pneumonia (VAP) is the nosocomial infection with the highest mortality. Although severe sepsis is considered one of the primary determinants of mortality in patients with VAP, the impact of organ failures on mortality in patients with VAP has not been well defined. The objective of this study was to determine if an association exists between the number of organ failures and mortality in patients with severe sepsis and VAP.
Methods: This was a retrospective study. The CDC definition of VAP was followed. The primary study outcome was mortality at 28 days. Stepwise logistic regression analysis was utilized to define the association between the number of organ failures and mortality. A p-value ≤ 0.05 was considered statistically significant.
Results: From a total of 308 patients with VAP, 251 (81.5%) patients were diagnosed with severe sepsis. Mortality risk according to organ failure compared to 1 organ was: for 2 organs 17 % (OR= 1.76, 95% CI 0.71-4.34, p= 0.219), for 3 organs 25 % (OR= 2.45, 95% CI 0.96 6.23, p= 0.06), for 4 organs 35% (OR=3.56, 95% CI 1.18-10.75, p= 0.024), and for 5 organs 46% (OR=5.66, 95% CI 1.50-21.40, p=0.010).
Conclusion: This study shows that severe sepsis is a commonly associated to VAP. Mortality in patients with VAP and severe sepsis is correlated with the number of organ failures. Effective treatment of organ failure is essential in this context because it is the cumulative burden of organ failure that leads to death.
Patricio Cabral, MD1, Martin Gnoni, MD2, Paula Peyrani, MD, Julio Ramirez, MD2, Silvia Uriarte, PhD4, Timothy Wiemken, MPH2 and  M. Gnoni, None..
T. Wiemken, None..
P. Peyrani, None..
P. Cabral, None..
S. Uriarte, None..
J. Ramirez, None., (1)Division of Infectious Diseases, University of Louisville, Louisville, KY, (2)University of Louisville, Louisville, KY, (3)Kidney Disease Program, University of Louisville, Louisville, KY