P5‐67: Predictors of mortality in severe COVID‐19 pneumonia: An interim analysis from a single Tertiary Care Centre in Central Sri Lanka

Abstract

the clinical and microbiologic characteristics, and their relationship with adverse clinical outcomes among patients with Ventilator Associated Pneumonia (VAP) admitted in Critical Care Unit in San Juan de Dios Hospital from 2016-2019. Method and Outcome Measures: The study used a retrospective cohort analysis which includes adult patients 18 years old and above admitted or transferred at critical care unit who were intubated and were diagnosed and treated as ventilator associated pneumonia (VAP). The relationship of the clinical characteristics of patients with VAP, antimicrobial resistance pattern and patient’s outcome including prolonged hospital stay (>21 days), ventilator dependence and mortality were measured. Results: A total of 164 patients were included. Mean time of hospital stay is 40 days in the MDR group (p-value 0.03). Presence of chronic lung disease is a significant risk factor in the development of VAP (p value 0.03). Mortality among patients with VAP is 53.7% and is significant in the MDR group (p value 0.05). Antibiotic use within the previous 90 days showed significance in mortality (OR 2.72; p value 0.003). Presence of chronic kidney disease is significant in developing ventilator dependence (OR 0.42, p value 0.05). Prolonged hospital stay of >21 days was significant among patients with previous antibiotic use (OR 3.2; p value 0.01). Conclusion: Recognition of the risk factors in the development of mortality among patients with VAP are significant to reduce adverse clinical outcomes. Avoiding adverse clinical outcomes requires the early use of appropriate antimicrobial therapy with broad coverage among the common pathogens based on local microbiologic data per institution.