Mortality predictors of Hospital acquired pneumonia (HAP) and Ventilator associated pneumonia (VAP) in tertiary hospital: A Single Center Retrospective Cohort Study

Abstract

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain significant causes of morbidity and mortality in a tertiary care hospital. Identifying specific mortality predictors is essential for optimizing clinical management resulting in better treatment outcomes. Leading to objective of this study which was to identify independent predictors associated with mortality and determine the mortality rate and common pathogens in HAP/VAP patients. A retrospective cohort study was conducted on patients diagnosed with HAP or VAP in the internal medicine wards of Khon Kaen Hospital between January 2023 and December 2024. Data were analyzed using univariable and multivariable binary logistic regression. The results found that a total of 252 patients were studied (70 improved, 133 deaths and 49 AMA) with a mortality rate of 52.8%. Multivariable analysis identified several independent predictors of mortality, including serum albumin (aOR 0.29 per 1-unit increase), hematologic malignancy (aOR 16.17), and impaired consciousness at the time of diagnosis (aOR 4.69). The most common pathogens identified were carbapenem-resistant Gram-negative bacteria, particularly Acinetobacter baumannii and Klebsiella pneumoniae. This study emphasized that mortality in HAP/VAP is high and influenced by both host factors and severe pathogen profiles. Early detection of high-risk patients, particularly those with low albumin levels, underlying malignancies and impaired level of consciousness at diagnosis, is essential for decreasing morbidity and mortality.