The Predictor of Adverse outcomes in Ventilator-Associated Pneumonia by Acinetobacter baumannii in the Intensive Care Unit = The Predictor of Adverse outcomes in Ventilator-Associated Pneumonia by Acinetobacter baumannii in the Intensive Care Unit

다국어 초록 (Multilingual Abstract)

The parameter of the response to treatment was not known previously in patient with VAP by A.baumannii (AB) in the ICU.We evaluate clinical outcomes and the predictor of adverse outcomes. 72 VAP patients were analyzed retrospectively. The early predictor associating 28-day mortality was analyzed. There was no significant difference in sex, carbapenem-resistance, APACHE-2 score at ICU admission and VAP episode, cause of MV, hospital days, ICU stay and duration of MV according survival. Non-survivors had old age > 65 years old, high Charlson cormorbidity score, medical patients, high SOFA score at ICU admission and high body temperature(BT) at VAP episode. There was no difference in inappropriate empirical/definitive antimicrobials and administration of colistin in both groups. Survivors had a lower CPIS, lower BT, improvement of P/F ratio and lower SOFA score at 7days or end of therapy of antimicrobials in univariate analysis. The lack of improvement of P/F ratio were independently associated with 28-day mortality in multiple logistic regression analysis (OR;15.33,95% CI;3.10-75.82,p<0.01). The improvement of P/F ratio was presented early at day 3 after starting empirical antimicrobials in survivor group (259.2±99.5vs199.1±94.9 mmHg,p=0.02). The SOFA score after receiving antimicrobials was declined at 7days in non-survivor group (9.4±4.3vs6.3±3.5t,p<0.01) .The lack of improvement of P/F ratio at day 7 could predict 28-day mortality in patients with VAP by AB. Survivors had the improvement of P/F ratio and the decline of SOFA score.