Ventilator-associated pneumonia (VAP) is one of the main healthcare-associated infections in the intensive care unit (ICU), contributing to increased morbidity and mortality, length of hospital stay, and hospital costs. Early identification of factors associated with its occurrence is essential for prevention and effective clinical management. To investigate factors associated with the occurrence of VAP in patients admitted to the ICU and undergoing invasive mechanical ventilation. Cross-sectional, analytical study conducted in an adult ICU with patients receiving mechanical ventilation. Individuals over 18 years of age, of both sexes, undergoing mechanical ventilation and receiving intensive care in the ICU were included. Binary logistic regression was performed considering VAP as the dependent variable. Independent variables included in the model were: length of ICU stay, mobility assessed by the Perme scale (the higher the score, the better the mobility), ventilatory modality, oxygenation level assessed by the PaO₂/FiO₂ ratio, and respiratory mechanics assessed by Driving Pressure. The significance level was set at 5%. The sample consisted of 102 patients, with a mean age of 67±15 years; 47% were male, 95% were admitted through emergency services, 8% developed VAP, and 54% died in the ICU. The model showed good fit (Hosmer–Lemeshow test; p = 1.000) and overall accuracy of 95.1%. Variables significantly associated with the occurrence of VAP were length of ICU stay (OR: 1.172; 95% CI: 1.037–1.323; p = 0.011), indicating that each additional day of ICU stay increases the risk of developing VAP by 17.2%, and PaO₂/FiO₂ ratio (OR: 0.982; 95% CI: 0.965–0.999; p = 0.041), indicating that better arterial oxygenation indices are associated with a lower chance of VAP diagnosis. The other variables in the model (mobility, ventilatory modality, and respiratory mechanics) were not statistically significant (p > 0.05). The occurrence of VAP in critically ill patients was significantly associated with length of ICU stay and arterial oxygenation. These findings reinforce the importance of strategies aimed at reducing ICU length of stay and improving respiratory function as preventive measures against VAP. Monitoring these indicators may assist in guiding protocols and multiprofessional interventions to reduce ventilator-associated infections.
Vieceli et al. (Sun,) studied this question.