Incidence rate and risk factors of ventilator-associated pneumonia in neurocritical patients with acute cerebrovascular diseases: A systematic review and meta-analysis of observational studies.

Authors

Julian Orlando Casallas-Barrera, Jenny Paola Garzón-Ruiz, Nicolás Alejandro Cuevas-Jiménez, Edwin Silva-Monsalve, Javier Torres-Zafra, Fabián Cortés-Muñoz, Gabriela Andrea Franco-Ballen, Laura María Bedoya, Ricardo Antonio Buitrago-Bernal

Published in

The Journal of international medical research. Volume 54. Issue 8. Pages 3000605261476804. Epub Aug 21, 2026.

Abstract

ObjectiveVentilator-associated pneumonia is a common complication among critically ill patients, particularly those with acute cerebrovascular diseases, including acute ischemic stroke, intracerebral hemorrhage, and aneurysmal subarachnoid hemorrhage. This study aimed to identify the factors associated with ventilator-associated pneumonia in patients with acute cerebrovascular diseases.MethodsA systematic review and meta-analysis were conducted using MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and Google Scholar. Studies involving patients aged ≥18 years who were hospitalized in an intensive care unit for >48 h, required mechanical ventilation, and had a primary diagnosis of ischemic stroke or aneurysmal subarachnoid hemorrhage were included. Risk of bias was assessed using a domain-based Risk of Bias in Non-randomized Studies of Interventions framework across all included studies, with complementary Newcastle-Ottawa Scale assessments for cohort and case-control studies. Data were analyzed using Review Manager. No publication-year restrictions were applied, and all eligible studies indexed up to the date of the final search were considered for inclusion.ResultsIn total, 16 studies involving 16,702 patients were included. The pooled incidence of ventilator-associated pneumonia was 31.62% (95% confidence interval: 24.82%-38.42%). Older age (≥65 years) (odds ratio: 2.74, 95% confidence interval: 1.68-4.48; p < 0.001) and chronic obstructive pulmonary disease (odds ratio: 2.03, 95% confidence interval: 1.05-3.93; p = 0.04) were significantly associated with ventilator-associated pneumonia, whereas diabetes mellitus demonstrated a borderline association (odds ratio: 1.52; 95% confidence interval: 1.00-2.29; p = 0.05). In contrast, arterial hypertension (odds ratio: 0.99; 95% confidence interval: 0.63-1.57; p = 0.98), tobacco use (odds ratio: 1.98, 95% confidence interval: 0.25-15.49, p = 0.51), and tracheostomy (odds ratio: 2.19, 95% confidence interval: 0.73-6.58; p = 0.16) were not consistently associated with ventilator-associated pneumonia. Risk of bias across the included studies was generally low to moderate.ConclusionVentilator-associated pneumonia remains a frequent complication among patients with acute cerebrovascular diseases. Older age and chronic obstructive pulmonary disease were consistently associated with an increased risk of ventilator-associated pneumonia in our study. These findings may improve the understanding of ventilator-associated pneumonia risk in this understudied neurocritical population and provide a foundation for future prospective studies evaluating targeted preventive interventions.

PMID:
42627133
Bibliographic data and abstract were imported from PubMed on 21 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.