Pneumonia is the sixth leading cause of death in the United States and is the leading cause of death from hospital-acquired infections In 2002, 35,967 patients died of hospital-acquired pneumonia. Ventilator-associated pneumonia or VAP, is defined as pneumonia that develops greater than or equal to 48 hours after a patient has been intubated and on a ventilator. Its mortality rate exceeds deaths due to central line infections, severe sepsis and other respiratory infection on non-intubated patients. Hospital mortality of ventilated patients who develop VAP is 46 percent compared to 32 percent for ventilated patients who do not develop VAP.(1),(2)

 

VAP is difficult to diagnose. A patient’s risk of dying from VAP is affected by multiple other factors, such as the patient's underlying disease(s) and organ failure, antecedent receipt of antimicrobial agent(s), and the infecting organism(s). Analyses of pneumonia-associated morbidity have shown that hospital-associated pneumonia can prolong ICU stay by an average of 4.3-6.1 days and overall hospitalization by 4-9 days.(2)

 

Costs & Reimbursement:

 

In addition, VAP prolongs time spent on the ventilator, length of ICU stay, and length of hospital stay after discharge from the ICU.(3)  An estimate of the direct cost of excess hospital stay due to VAP is $40,000 per patient.(4)

 

References:

(1) IHI Getting Started Kit: Prevent Ventilator-associated Pneumonia How-to Guide


(2) Ibrahim E.H., Tracy L., Hill C., et al. The occurrence of ventilator-associated pneumonia in a community hospital: Risk factors and clinical outcomes. Chest. 2001 Aug;120(2):555-561.

 

(3) Rello J., Ollendorf D.A., Oster G., et al. VAP Outcomes Scientific Advisory Group. Epidemiology and outcomes of ventilator-associated pneumonia in a large U.S. database. Chest. 2002 Dec;122(6):2115-2121.

 

(4) Tablan O.C., Anderson L.J., Besser R., et al. CDC Healthcare Infection Control Practices Advisory Committee. Guidelines for preventing healthcare-associated pneumonia, 2003: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004 Mar 26;53(RR-3):1-36.