Ventilator associated pneumonia (VAP) statistics

Ventilator associated pneumonia (VAP)  was first recognized around 1972, and by 2002 the Centers for Disease Control and Prevention (CDC) released guidelines designed to prevent VAP.  Since these guidelines were passed the statistics actually look pretty good.

While VAP statistics vary from study to study, the following are some of the results:

1. Pneumonia is the second most common nosocomial infection in the United States at 27% (urinary tract infections is number one at 31%, and blood stream infections is #3 at 19%), according to the CDC
2. Pneumonia is a leading cause of death due to hospital-acquired infections.
3. In 2002, US hospitals reported an estimated 250,000 cases of healthcare-associated pneumonias—36,000 related to deaths, according to the CDC
4. 5-20% of patients wo require mechanical ventilation for greater than 48 hours will develop VAP, and th associated mortality is 15-50%, according to Lorente et al and Porzecanski et al
5. ICU stays in patients with VAP is increased by a mean of 6.1 days, and the excess cost can be as high as $40,000 per patient, according to Restrepo et al and Warren et al. 
6. The VAP death rate is 30%, or between 27% and 43%
7. In 2007, The incidence of VAP in 2007 was 22.8% 
8. In 20007, VAP account for 86% of all cases of nosocomial pneumonia.
9. In 2007, intubated patients had a 3-10 fold greater risk of catching pneumonia
10. The mortality rate attributable to VAP is 27% 
11. The mortality rate is as high as 43% when the causative agent was antibiotic resistant
12. Length of stay in the intensive care unit is increased by 5 to 7 days
13. Hospital length of stay was increased 2- to 3-fold
14. In 2014, the cost is estimated to be an additional $40,000 per hospital admission per patient, and an estimated $1.2 billion per year.
15. By 2012, the number of VAP incidents dropped to 3,957
16. With each day of mechanical ventilation and intubation, the crude VAP rate increases by 1% to 3% and the death risk increases from two-fold to 10-fold
17. The American Thoracic Society reported that ventilator-associated pneumonia occurs in 9% to 27% of all intubated patients.
18. A study published in the American Journal of Respiratory and Critical Care Medicine indicated that an estimated 5.9% of ICU deaths through day 60 could be attributed to VAP.
19. Healthcare costs can increase more than $57,000 per incident of VAP.
20. VAP prevention can reduce both the cost and morbidity associated with mechanical ventilation.

Early statistics, which did not look good, were used as incentives to create guidelines for institutions to institute policies and procedures to reduce these rates. Later statistics show these efforts have worked.

References:

1. Van Hooser, Theron, "Ventilator Associated Pneumonia: Best Practice Strategies for Caregivers," 2002, http://en.haiwatch.com/data/upload/tools/VAP_CEU_Booklet_Z0406.pdf, Kimberly Clark Co., accessed 4/21/14
2. "Protocols and Definitions Device-associated Models: Ventilator Associated Pneumonia," Centers for Disease Control, http://www.cdc.gov/nhsn/PDFs/slides/VAP-DA_gcm.pdf, accessed 4/21/14
3. "Intubation And VAP: A Complex Condition Requires Bundled Solution," rtmagazine.com, http://www.rtmagazine.com/2014/04/intubation-vap-complex-condition-bundled-solutions/, accessed 4/23/14
4. Bowton, David L, R. Duncan Hite, Shayne Martin, and Robert Sheretz, "The Impace of Hospital-Wide Use of a Tapered-Cuff Endotracheal Tube on the Incidence of Ventilator-Associated-Pneumonia," Respiratory Care, October, 2013, volume 58, number 10, pages 1582-1587