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Byline: J. Valles (1), A. Pobo (1), O. Garcia-Esquirol (1), D. Mariscal (2), J. Real (3), R. Fernandez (1) Keywords: Ventilator-associated pneumonia; Attributable mortality; Morbidity; Late-onset pneumonia Abstract: Objective To determine the impact of ventilator-associated pneumonia (VAP) on ICU mortality, and whether it is related to time of onset of pneumonia. Design Prospective cohort study. Setting 16-bed medical-surgical ICU at a university-affiliated hospital. Patients and measurements From 2002 to 2003, we recorded patients receiving mechanical ventilation for >a-72a-h. Patients developing an infection other than VAP were excluded. Patients definitively diagnosed with VAP (na-=a-40) were cases and patients free of any infection acquired during ICU stay (na-=a-61) were controls. The VAP-attributed mortality was defined as the difference between observed mortality and predicted mortality (SAPSa-II) on admission. Results Mechanical ventilation was longer in VAP patients (25a-+-a-20 vs 11a-+-a-9a-days pa-a-0.2). In the VAP group, observed mortality was 45% and predicted mortality 26.5% (pa-a-0.20) in late-onset VAP, observed mortality was higher (51.7 vs 26.7% pa- Conclusions In mechanically ventilated patients, VAP is associated with excess mortality, mostly restricted to late-onset VAP and despite appropriate antibiotic treatment. Author Affiliation: (1) Critical Care Center, Parc Tauli s/n, Hospital Parc Tauli, 08208, Sabadell, Spain (2) Department of Microbiology, Parc Tauli s/n, Hospital Parc Tauli, 08208, Sabadell, Spain (3) Department of Epidemiology, Parc Tauli s/n, Fundacio Parc Tauli, 08208, Sabadell, Spain Article History: Registration Date: 07/05/2007 Received Date: 25/04/2006 Accepted Date: 06/04/2007 Online Date: 09/06/2007