Neuroanesthesia & neurocritical care
Risk factors and outcomes of ventilator-associated pneumonia in patients with traumatic brain injury: A systematic review and meta-analysis
Authors' conclusion
Male gender, H-AIS ≥ 3, blood transfusion on admission, and barbiturate infusion were risk factors for VAP. In patients with VAP, ICU stay, duration of mechanical ventilation, hospital stay were significantly increased.
Study context
- Population
- Patients with traumatic brain injury (TBI) and mechanical ventilation
- Participants
- 2,883 patients · 12 studies
- Comparison
- Ventilator-associated pneumonia (VAP) vs no VAP in TBI patients
- Outcome
- Risk factors and clinical outcomes of VAP
Methodological detailsrandom-effects or fixed-effects model by heterogeneity, subgroup analysis, GRADE certainty assessment
- Random-effects or fixed-effects model by heterogeneity
- Subgroup analysis
- GRADE certainty assessment
Pooled result
As reported in the abstract
Risk factors for VAP
Odds ratio (95 % CI)P value
Male genderI2 0 %
1.58(1.23–2.02)
P < 0.05H-AIS ≥ 3I2 0 %
2.79(1.58–4.93)
P < 0.05Blood transfusion on admissionafter subgroup analysis; I2 5 %
1.97(1.16–3.35)
P ≤ 0.05Barbiturate infusionafter subgroup analysis; I2 0 %
3.55(2.01–6.30)
P ≤ 0.05Prophylactic antibiotic useprotective; I2 0 %
0.67(0.51–0.88)
P ≤ 0.05MD (95 % CI)P value
Younger ageprotective; I2 41 %
−3.29(−5.18 to −1.40)
P ≤ 0.05Further pooled results
| Outcome | MD (95 % CI) | P value | |
|---|---|---|---|
| Outcomes in VAP patientsVAP vs No VAP · ICU stay; I2 37 % | 7.02 (6.05–7.99) | P ≤ 0.05 | |
| Outcomes in VAP patientsVAP vs No VAP · duration of mechanical ventilation; I2 79 % | 5.79 (4.40–7.18) | P ≤ 0.05 | |
| Outcomes in VAP patientsVAP vs No VAP · hospital stay; I2 0 % | 11.88 (8.71–15.05) | P ≤ 0.05 | |
| −1001020Difference (linear scale) |
Outcomes in VAP patients
- Certainty of evidence moderate-high
Original publication
Risk factors and outcomes of ventilator-associated pneumonia in patients with traumatic brain injury: A systematic review and meta-analysis. J Crit Care. Published 2 October 2024. doi:10.
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