Prevalence, risk factors, and outcomes of patients with Ventilator Associated Pneumonia (VAP) among adult patients on invasive mechanical ventilation admitted to intensive care units in comprehensive specialized hospitals in Northwest Ethiopia. A retrospective follow- up study

Introduction : Ventilator associated pneumonia is a major cause of morbidity and mortality among patients on mechanical ventilation. Moreover, it extends the time on mechanical ventilation and duration of hospitalization, which resulting increased cost of care. However, there is limited data from African countries, including Ethiopia. Therefore, this study aimed to assess the prevalence and its associated factors of ventilator associated pneumonia among adult patients on invasive mechanical ventilation admitted in comprehensive specialized hospitals in Northwest Ethiopia. Methods An institutional-based retrospective follow-up study was conducted from January 1, 2020, to December 31, 2022. A simple random sampling was used to select a total of 331 patients’ charts. Data were collected using data the extraction tool, entered into Epi-data version 4.6.0, and exported to STATA version 14 for analysis. The binary logistic regression model was fitted, and variables with a p-value < 0.25 in the bivariable binary logistic regression analysis were candidates for the multivariable binary logistic regression analysis. An Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was computed to evaluate the strength of the association, and variables with a p-value < 0.05 at a 95% confidence interval were considered statistically significant. Results The current study found that the prevalence of VAP among patients receiving invasive mechanical ventilation was 19.6% (95% CI: 15.7, 23.9). Among a total of 65 patients with VAP admitted to the ICU, 76.9%, 15.4%, 3.2%, 3.2%, and 1.5% were died, transferred to wards, referred out, left against medical advice, and discharged to their homes, respectively. Based on the multivariable binary logistic regression analysis, patients who had sepsis (AOR: 2.87, 95% CI: 1.12, 7.35), GCS score < 8 (AOR: 3.23, 95% CI: 1.49, 7.02), length of stay in MV > 7 days (AOR: 4.14, 95% CI: 1.19, 14.46), and history of previous mechanical ventilation (AOR: 4.60, 95%CI: 1.76, 12.05) were significantly associated with VAP among mechanically ventilated patients admitted to the ICU. Conclusion and recommendations: The prevalence of VAP among patients receiving an invasive mechanical ventilation was high, and more than three-fourths were died in the ICU. GCS score < 8, length of stay in MV > 7 days, sepsis, and history of previous mechanical ventilation were significantly associated with VAP among mechanically ventilated patients admitted to the ICU. The healthcare provider should have carried out VAP preventive measures for the above risk factors.