Risk Factors for Ventilator-Associated Pneumonia in Elderly ICU Patients: A Meta-Analysis

Lu  Che; Haonan  Zhang; Kaili  Xing

doi:10.18502/ijph.v54i8.19574

Lu Che Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China
Haonan Zhang Hangzhou First People’s Hospital, Hangzhou 310000, Zhejiang, China
Kaili Xing Hangzhou First People’s Hospital, Hangzhou 310000, Zhejiang, China

DOI: https://doi.org/10.18502/ijph.v54i8.19574

Keywords: Elderly; Ventilator-associated pneumonia; Risk factors; Meta-analysis

Abstract

Background: To systematically evaluate the risk factors of ventilator-associated pneumonia (VAP) in critically ill elderly patients in intensive care unit (ICU).

Methods: The China National Knowledge Infrastructure (CNKI), Wanfang Database, PubMed and Web of science databases were searched to collect the literature published at home and abroad on the risk factors of ventilator-associated pneumonia in critically ill elderly patients in ICU. The publication date of the literature was up to Oct 24, 2024. Meta-analysis was performed using Stata SE14.0 software to calculate the Odds ratio (OR) and 95% Confidence intervals (CIs) of each risk factor.

Results: Thirteen articles were included, all of which were case-control studies. Age, glucocorticoids, mechanical ventilation ≥7 d, tracheotomy, gastrointestinal feeding nutrition, and acute physiological and acute physiology and chronic health evaluation ⅱ(APACHEII) score ≥15 were the risk factor for VAP in ICU patients (OR (95%CI) were 1.044 (1.004, 1.086), 4.663 (2.098, 10.363), 2.749 (1.912, 3.952), 7.405 (2.040, 26.884), 2.676 (1.888, 3.794), 1.822 (1.198, 2.771).

Conclusion: Clinical interventions targeting age, glucocorticoid use, mechanical ventilation ≥7 days, tracheotomy, gastrointestinal feeding nutrition, and APACHEII ≥15 should be prioritized to reduce VAP incidence in critically ill elderly ICU patients.