Table 4: Multivariate odds ratios (OR) for mortality, with 95% confidence intervals (CI) Ventilated patients (n=1516) Patients with a CVC (n=1604) Patients with a urinary catheter (n=2259) OR 95% CI OR 95% CI OR 95% CI Age ≤39 years 40‐70 years ≥ 70 years 1 1.7** 3.0** (1.1‐2.8) (1.9‐4.8) 1 1.3 2.7** (0.8‐2.2) (1.6‐4.5) 1 1.6** 2.8** (1.0‐2.5) (1.8‐4.4) APACHE II score 0‐19 ≥20 1 1.9** (1.5‐2.4) 1 1.7** (1.3‐2.3) 1 1.9** (1.5‐2.4) Specialty Surgery/traumatology Internal medicine Cardiology/‐surgery Neurology/‐surgery Other 1 1.7** 2.4** 1.8** 1.3 (1.5‐2.7) (1.6‐3.6) (1.2‐2.8) (0.8‐2.1) 1 2.1** 2.4** 1.9** 1.8** (1.5‐2.9) (1.6‐3.6) (1.2‐3.2) (1.1‐2.8) 1 1.9** 2.6** 1.8** 1.4 (1.4‐2.7) (1.8‐3.8) (1.2‐2.7) (0.9‐2.2) Admission Planned Acute 1 1.4** (1.0‐1.8) Systemic antibiotics at admiss. No Yes 1 1.6** (1.1‐2.4) 1 1.4 (0.9‐2.1) 1 1.5** (1.1‐2.3) Ventilation No Yes 1 3.9** (2.5‐6.0) 1 4.8** (3.3‐7.0) CVC No Yes 1 1.7** (1.2‐2.3) 1 1.8** (1.3‐2.5) Duration of device use < 4 days 5‐14 days >15 days 1 1.5** 1.6** (1.1‐2.0) (1.1‐2.2) 1 1.6** 2.8** (2.0‐4.0) (2.5‐6.0) * 0.05 < p < 0.1; ** p < 0.05 (70% and 86%, respectively). These differences could be the result of different selections of patient populations (all ICU patients in NNIS vs. patients staying at least 48 h in this study) which is likely to be reflected in their need of device assistance, but also of differences in patient management. The inclusion criterion of ICU stay 48 h or longer in our study probably resulted in higher infection incidence rates. Also, some publications report incidence density rates calculated with all ICU or device days instead of the number of days up to infection, resulting in lower rates, as pointed out for ventilated patients by Eggimann et al [10]. This is the case with figures derived from NNIS data [9]. Our pneumonia rate of 19% in ventilated patients and 25 per 1,000 ventilator days falls within the reported rates in more recent studies with comparable methods of diagnosing VAP (cultures usually from endotracheal aspirates or sputum): 9.8/1,000 30 Chapter 2
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