AUTHOR=Sun Ke , Peng Fangchen , Xu Kaiqiang , Liu Yong , Zhou Xuanping , Shang Nan , Li Chao 

TITLE=A novel multivariate logistic model for predicting risk factors of failed treatment with carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1385118

DOI=10.3389/fpubh.2024.1385118

ISSN=2296-2565

ABSTRACT=Background: This study aimed to explore the risk factors for failed treatment of Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia ( CRAB-VAP ) with tigecycline and to establish a predictive model to predict the incidence of failed treatment and the prognosis of CRAB-VAP.Methods: A total of 189 CRAB-VAP patients were included in the safety analysis set from two Grade 3 A National-level hospitals between January 1, 2022 to December 31, 2022. Risk factors of failed treatment with CRAB-VAP were identified using univariate, multivariate logistic analysis, and establishing independent a nomogram to show the results.Results: Of the 189 patients, 106 (56.1%) cases in successful treatment group, 83 (43.9%) cases in failed treatment group. The multivariate logistic model analysis showed that age (OR = 1.04, 95% CI:1.02, 1.07, P = 0.001), yes. of hypoproteinemia (OR = 2.43, 95% CI: 1.20, 4.90, P = 0.013), daily dose of 200 mg (OR = 2.31, 95% CI: 1.07, 5.00, P = 0.034), yes. of medication within 14days prior to surgical intervention (OR = 2.98, 95% CI: 1.19, 7.44, P = 0.019), no. of microbial clearance (OR = 0.31, 95% CI: 0.14, 0.70, P = 0.005) were risk factors for the failure of tigecycline treatment, Receiver Operating Characteristic (ROC) analysis showed the AUC area of the prediction model was 0.745 (0.675 -0.815), and Decision Curve Analysis (DCA) showed that the model was effective in clinical practice.: Age, hypoproteinemia, daily dose, medication within 14days prior to surgical intervention, and microbial clearance represent significant risk factors for the failed treatment with 2 CRAB-VAP, and the nomogram predicated a high age was the most important factor. The failed treatment rate of CRAB-VAP with tigecycline was high, this prediction model can help doctors correct or avoid risk factors in clinical treatmen.