Department of Biostatistics

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Author: search.filters.author.Masresha Gebru

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    PREDICTORS AND TIME TO PNEUMONIA DEVELOPMENT IN MECHANICALLY VENTILATED ADULT PATIENTS IN THE ICU AT AYDER COMPREHENSIVE SPECIALIZED HOSPITAL, MEKELLE, TIGRAY 2024
    (Mekelle University, 2024-10-20) Masresha Gebru
    Introduction: Ventilator-Associated Pneumonia (VAP) is the second most common nosocomial infection in the intensive care unit (ICU). Researchers have conducted limited studies, and identifying the factors linked to the development of VAP is crucial for implementing preventive measures. Objective: To determine predictors and time to pneumonia development in mechanically ventilated adult patients in the intensive care unit at Ayder Comprehensive Specialized Hospital, Mekelle, Tigray 2024. Methods and Materials: A retrospective cohort study design was employed. All patients admitted to the adult intensive care unit and under mechanical ventilation from January 1, 2018, to December 31, 2020, were recruited consecutively. Data was collected using ODK and exported to STATA 17 for analysis. Log-rank test and multivariable lognormal regression were fitted to identify time to pneumonia development predictors. An adjusted hazard ratio with a 95% confidence interval was used to measure the association. The lognormal model best fits the data based on goodness-of-fit criteria, including the Akaike Information Criterion and Bayesian Information Criterion. The assumptions of survival times were checked using graphical methods. Models with and without interaction terms were compared, and the final model was selected based on the best fit to the data. Result: Data from 203 patient folders were analyzed, with a median follow-up of 6 days. The overall occurrence of pneumonia among adult patients in the ICU under mechanical ventilation was 61.08%, with an incidence rate of 15.3 cases per 813 person-days. The duration of mechanical ventilation for late pneumonia (AHR=1.32, 95% CI: 1.13, 1.55), cause of admission to intensive care unit due to respiratory disease (AHR=0.72, 95% CI: 0.53, 0.93), primary indication for intubation for patient with trauma (AHR=0.72, 95% CI: 0.53, 0.98), Sex of patient female patients (AHR=0.85, 95% CI 0.73, 0.98) were significantly associated with VAP in the adult ICU patients. Conclusions and Recommendation: The study highlights high pneumonia incidence in mechanically ventilated patients, emphasizing prioritizing resources allocation for those who are under mechanical ventilation to minimize the incidence of pneumonia.