Figure 9. Trajectory analysis reveals that unresolving VAP is associated with transitions to progressively unfavorable clinical states.

On these Sankey diagrams, day 0 represents the day that a BAL procedure was performed to evaluate VAP adjudicated as (A) cured, (B) indeterminate, or (C) not cured. More favorable (lower mortality) clinical states are at the top of the graphs, with leaving the ICU alive being the highest, and less favorable (higher mortality) clinical states are at the bottom, with death being the lowest. Graphs start at 2 days prior to the onset of the episode; patients who were not in our ICU are labeled as “Other” (patients who were received in external transfer or chronically ventilated patients) or “Floor” (within 48 hours of extubation or chronically ventilated patients). readm., readmission.