PREVALENCE AND ASSOCIATED FACTORS OF VENTILATORASSOCIATED PNEUMONIA AMONG INTUBATED PATIENTS IN HIWOT FANA SPECIALIZED COMPREHENSIVE HOSPITAL, HARAR, ETHIOPIA

Abstract

Ventilator-associated pneumonia refers to pneumonia that develops in patients receiving mechanical ventilation for at least 48 hours. It is associated with an increased duration of mechanical ventilation, longer stays in the intensive care unit, and higher mortality. The prevalence ranges from 10 to 25% in tertiary care hospitals, but can reach as high as 76% in certain settings and high mortality. This study aims to examine the prevalence and associated factors of ventilator-associated pneumonia to implement more effective preventive measures and reduce morbidity and mortality. Objective: To assess the prevalence and associated factors of ventilator-associated pneumonia in intubated patients at the Hiwot Fana and Harme Intensive Care Units from December 23, 2024 to January 10, 2025. Method: Institutional-based cross-sectional study was conducted among 171 intubated patients on invasive mechanical ventilation for more than 48 hours at Hiwot Fana Comprehensive Specialized Hospital (Harme and Hiwot fana intensive care units) from January 1, 2021, to June 30, 2024. Data were collected from patient charts using a structured checklist, which were pretested before use. The data from Kobotool box was then exported to STATA version 17 for cleaning and analysis. Adjusted odds ratios with 95% confidence intervals were calculated and associated factors with a p-value less than 0.05 were considered significant. Results: Overall 171 study participants were included in this study, 46 developed VentilatorAssociated Pneumonia during their intensive care unit stay, resulting in a prevalence of 26.90% (95% CI: 21.03% -32.77%) The total ventilator days were found to be 1976 days; the median ventilator-days were 7 days with a minimum of 3 days and a maximum of 120 days. Based on onset, 9(19.6%) patients had early onset Ventilator-Associated Pneumonia and the remaining 37 (80.4%) had late onset Ventilator-Associated Pneumonia. Blood transfusion (adjusted odds ratio (AHR): 2.68, 95% CI: 1.03–4.98; P = 0.042), Tracheostomy (AHR: 0.28, 95% CI: 0.08–0.75; P =0.014), and increased duration of MV (AHR: 4.1, 95% CI: 1.49–10.32; P = 0.005) were significantly associated with the development of Ventilator-Associated Pneumonia. Conclusions: Nearly one-fourth of the participants developed ventilator-associated pneumonia. Blood transfusion, tracheostomy and duration of mechanical ventilation were significantly associated with ventilator-associated pneumonia.