Factors Predictive of Ventilator-associated Pneumonia in Critically Ill Trauma Patients

  • Duraid YounanEmail author
  • Sarah J. Delozier
  • John Adamski
  • Andrew Loudon
  • Aisha Violette
  • Jeffrey Ustin
  • Glen Tinkoff
  • Matthew L. Moorman
  • Nathaniel McQuay
  • UHRISES Research Consortium
Original Scientific Report



Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation. We sought to investigate factors associated with the development of VAP in critically ill trauma patients.


We conducted a retrospective review of trauma patients admitted to our trauma intensive care unit between 2016 and 2018. Patients with ventilator-associated pneumonia were identified from the trauma database. Data collected from the trauma database included demographics (age, gender and race), mechanism of injury (blunt, penetrating), injury severity (injury severity score “ISS”), the presence of VAP, transfused blood products and presenting vital signs.


A total of 1403 patients were admitted to the trauma intensive care unit (TICU) during the study period; of these, 45 had ventilator-associated pneumonia. Patients with VAP were older (p = 0.030), and they had a higher incidence of massive transfusion (p = 0.015) and received more packed cells in the first 24 h of admission (p = 0.028). They had a higher incidence of face injury (p = 0.001), injury to sternum (p = 0.011) and injury to spine (p = 0.024). Patients with VAP also had a higher incidence of acute kidney injury (AKI) (p < 0.001) and had a longer ICU (p < 0.001) and hospital length of stay (p < 0.001). Multiple logistic regression models controlling for age and injury severity (ISS) showed massive transfusion (p = 0.017), AKI (p < 0.001), injury to face (p < 0.001), injury to sternum (p = 0.007), injury to spine (p = 0.047) and ICU length of stay (p < 0.001) to be independent predictors of VAP.


Among critically ill trauma patients, acute kidney injury, injury to the spine, face or sternum, massive transfusion and intensive care unit length of stay were associated with VAP.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict interests.

Informed consent

Informed consent was waived by the institution review board.


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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Duraid Younan
    • 1
    Email author
  • Sarah J. Delozier
    • 2
  • John Adamski
    • 1
  • Andrew Loudon
    • 1
  • Aisha Violette
    • 1
  • Jeffrey Ustin
    • 1
  • Glen Tinkoff
    • 1
  • Matthew L. Moorman
    • 1
  • Nathaniel McQuay
    • 1
  • UHRISES Research Consortium
    • 3
  1. 1.Division of Trauma, Critical Care and Acute Care Surgery, Department of SurgeryUniversity Hospitals ClevelandClevelandUSA
  2. 2.Center for Clinical ResearchUniversity Hospitals ClevelandClevelandUSA
  3. 3.Department of Surgery, University Hospitals Research in Surgical Outcomes and Effectiveness CenterUniversity Hospitals ClevelandClevelandUSA

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