Risk factors and outcomes of ventilator-associated pneumonia: an updated systematic review and meta-analysis
Abstract
Ventilator-associated pneumonia (VAP) is a common complication in intensive care unit (ICU) patients, which increases morbidity rates and adversely affects outcomes. The associated risk factors and outcomes remain controversial. The aim of the present study is to explore the risk factors and clinical outcomes of patients with VAP. Two investigators conducted independent systematic Literature searches of Pubmed, Cochrane Database, Scopus, Medline, Science Direct and Epistemonikos databases published from inception to November 2024. The Newcastle-Ottawa Scale (NOS) was used to assess study quality. A meta-analysis was performed using the random-effects Model. The systematic review protocol was registered in the CRDdatabase 42024538138 of the Prospective International Registry of Systematic Reviews (PROSPERO). A subgroup analysis, bivariate meta-regression, and sensitivity analysis were performed. Publication bias was assessed using a funnel plot and Egger's test. Certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. Twenty-two studies were included in the meta-analysis, with a total of 16,731 patients. Male gender odds ratio (OR) 1.30 (95% Confidence interval (CI) 1.18-1.44) p<0.05; the use of H2 blockers OR 2.24 (95% CI 1.50-3.37) p<0.05; tracheostomy OR 3.44 (95% CI 2.0-5.92) p<0.05; prior antibiotic treatment OR 1.52 (95% CI 1.08-2.15) p<0.05; reintubation OR 5.11 (95% CI 2.29-11.42) p<0.05;…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 16,731 participants or records.
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