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| Meta-analysis of risk factors for ventilator-associated pneumonia in adult patients with ICU |
| FANG Jinlin HUANG Yanzhou YE Hongfang |
| Department of Hematology, Nanjing Drum Tower Hospital, the Affiliated of Nanjing University Medical School, Jiangsu Province, Nanjing 210008, China |
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Abstract Objective To systematically evaluate the risk factors of ventilator-associated pneumonia (VAP) in adult patients in the intensive care unit (ICU). Methods Chinese Knowledge Network, Wanfang, VIP, PubMed, Cochrane Library and Web of Science were searched to collect publicly published studies on the risk factors of VAP in adult patients with ICU at home and abroad, from January 2009 to December 2018. Literature review was conducted independently by two evaluators following the criteria for inclusion. If there were differences, a third-party evaluation was conducted to discuss and select the literature that met the inclusion criteria. Revman 5.3 software was used for meta-analysis and the combined odds ratio (OR) of each risk factor was calculated. Results A total of 12 articles were included in the study, all of which were case-control studies. Age≥60 years, mechanical ventilation time≥7 days, coma, acute physiological and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) ≥ 15 points, use of antibiotics, antacids, and tracheotomy are risk factors for VAP in adult patients with ICU (OR ＞ 1, P ＜ 0.05). Conclusion Adult patients in ICU who are older, have longer mechanical ventilation, are in a coma, have higher APACHE Ⅱ scores, use antibiotics, use antacids, and have tracheostomy are more likely to cause VAP. Whether parenteral nutrition is a risk factor for VAP in adult patients with ICU may be related to the way parenteral nutrition is administered.
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