HRC 2012-2017 PAV
Description
This data assessed ICU patients over a six-year period, focusing on the role of dental procedures and plaque removal. The incidence of VAP was tracked in relation to the frequency and interval of dental consultations. A logistic regression was performed to associate VAP occurrence with variables such as consultation intervals, dental procedures, duration of mechanical ventilation (MV), age, among others. The findings revealed a significant reduction in VAP incidence over time, with a lower risk observed in 2017 compared to 2012. Shorter intervals between dental consultations were linked to a decrease in VAP cases. No association was found between undergoing dental procedures and an increased risk of VAP; however, patients requiring these interventions appeared more vulnerable. Additionally, older patients (over 52 years) and those on MV for more than 10 days exhibited a higher risk of developing VAP. Dental interventions in the ICU, particularly when performed early and at shorter intervals, contribute to the reduction of VAP incidence. These findings underscore the importance of integrating regular dental care into ICU protocols, emphasizing the potential for improved outcomes with systematic oral care. Although dental procedures themselves do not increase the risk of VAP, early interventions aimed at controlling plaque and infection sources seem crucial for patient outcomes.
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Contingency tables were constructed to analyze the relationship between the variables and the presence of ventilator-associated pneumonia (VAP). Simple logistic regression models were then estimated, calculating the crude odds ratios with corresponding 95% confidence intervals. Following this, multilevel multiple logistic regression models were estimated, considering individual-level variables (first level) and contextual-level variables (year - second level). The year was considered a contextual variable because it was related to a specific group of patients. All variables with p≤0.20 in the simple analyses were tested in the multiple models, and those with p≤0.05 remained in the models. From the multiple models, adjusted odds ratios with 95% confidence intervals were estimated. Nonparametric Kruskal-Wallis and Dunn tests were used to compare the number of dental consultations, the interval between dental consultations, the length of ICU stay, and the duration of mechanical ventilation across the years. A correlation analysis between the VAP incidence rate and the year was also conducted. All analyses were performed using the R program (R Core Team, 2018. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria), with a significance level of 5%.