A Study among Trauma Patients - Younger Patients with Ventilator Associated Pneumonia Have Poor Outcome Compared to Older Patients, Government General Hospital, Nizamabad

Author(s): L. Ramulu1 , Sujay Kumar Parasa2 , Thirupathi Rao J.3 , Kiran Madhala4

BACKGROUND Considerable morbidity is associated with ventilator-related pneumonia. Although gender association with outcomes in trauma patients has been debated for years, some authors have shown a difference recently. We wanted to compare results in younger men and women, with those of older men and women in critically ill patients with pneumonia (VAP) combined with ventilator. METHODS We reviewed our trauma database between May 2018 and January 2020 for patients with ventilator-associated pneumonia admitted to our Intensive Trauma Care unit. Data obtained included age, accident cause and severity (ISS), vital signs at the time of admission, test results as well as outcome factors including hospital duration of stay, ICU stay and survival. In order to account for the hormonal status, patients were also divided into younger (< 50) and older (about 50). Linear regression and binary logistic regression models were developed to compare younger men with older men and younger women with older women, and investigate the correlation between gender and hospital length of stay (LOS), ICU stay (ICUS) and survival. RESULTS 42 trauma patients admitted to our trauma intensive care unit during the study period had VAP. The average age with mean ISS of 196 ± 7.8 was 56.9 ± 18.7 years. There were 26 (61.90%) men, 16 (38.10%) women and 38 (90.48%) men who had blunt trauma. The median ICU stay was 15.6 ± 10.6 days and the median overall period of stay in hospital (LOS) was 23.5 ± 13.5 days. Younger men with VAP had longer 26.6 ± 16.6 days in the hospital relative to older men 14.4 ± 5.6 days (p= 0.061) and 20.7 ± 14.3 days in the intensive care unit compared to older men 10.9 ± 6.2 days (p= 0.079), there was no substantial change of extent of injuries (ISS was 22.8 ± 6.9 vs. 18.90 ± 1.6, p= 0.131). CONCLUSIONS In trauma patients with VAP, there was a longer hospital stay for younger people, and a trend for longer ICU stay. Using a broader collection, further research is necessary to evaluate the factors behind the disparity in results.