Prediktor Mortalitas Pasien dengan Ventilator-Associated Pneumonia di RS Cipto Mangunkusumo

Riahdo J. Saragih, Zulkifli Amin, Rudyanto Sedono, Ceva W. Pitoyo, Cleopas M. Rumende

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Ventilator-associated pneumonia (VAP) is a frequently found infection with high mortality rates in intensive care unit (ICU). The prediction of outcome is important in decision-making process. To determine predictors of mortality in patients with VAP in Cipto Mangunkusumo Hospital (CMH), we performed a retrospective cohort study on patients admitted to the ICU who developed VAP between 2003–2012. Clinical and laboratory data along with outcome status were obtained for analysis. We compared age, presence of high-risk pathogens infection, presence of comorbidity, septic shock status, blood culture result, procalcitonin, appropriateness of initial antibiotics therapy, presence of acute lung injury, APACHE II score, and serum albumin between the two-outcomegroups. Logistic regression analysis was performed to identify independent predictors of mortality. A total of 201 patients were evaluated in this study. In-hospital mortality rate was 57.2%. Age, comorbidity, septic shock status, procalcitonin, appropriateness of initial antibiotics therapy, and APACHE II score were significantly different between outcome groups. The independent predictorsof mortality in multivariate logistic regression analysis were inappropriate initial antibiotics therapy (OR: 4.70; 95% CI 2.25 to 9.82; p < 0.001), procalcitonin > 1.1 ng/mL (OR: 4.09; 95% CI 1.45 to 11.54; p = 0.01), age ≥ 60 years old (OR: 3.71; 95% CI 1.35 to 10.20; p = 0.011), and presence of septic shock (OR: 3.53; 95% CI 1.68 to 7.38; p = 0.001). It was concluded that inappropriate initial antibiotic therapy, high serum procalcitonin, age 60 years or older, and septic shock were independent predictors of mortality in patients with VAP.
Original languageIndonesian
Journale-Journal Kedokteran Indonesia
Issue number2
Publication statusPublished - 2014

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