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Mortality related to hospital-associated infections in a tertiary hospital; repeated cross-sectional studies between 2004-2011.

Koch AM, Nilsen RM, Eriksen HM, Cox RJ, Harthug S - Antimicrob Resist Infect Control (2015)

Bottom Line: The data were analysed by Kaplan-Meier survival analysis and by multiple Cox regression analysis, adjusted for year of registration, time period, sex, type of admission, Charlson comorbidity index, surgical operation, use of urinary tract catheter and time from admission to the prevalence survey date.Subgroup analyses revealed that patients with BSI, LRTI or more than one simultaneous infection had an increased risk of death.BSI, LRTI and more than one simultaneous infection were independently and strongly associated with increased mortality 30 days and 1 year after inclusion in the study.

View Article: PubMed Central - PubMed

Affiliation: Department of Research and Development, Haukeland University Hospital, Jonas Liesv. 65, 5021 Bergen, Norway ; Department of Clinical Science, University of Bergen, Jonas Liesv. 87, Bergen, Norway.

ABSTRACT

Background: Hospital-associated infections (HAIs) are reported to increase patient mortality and incur longer hospital stays. Most studies to date have focused on specific groups of hospitalised patients with a rather short follow-up period. In this repeated cross-sectional study, with prospective follow-up of 19,468 hospitalized patients, we aimed to analyze the impact of HAIs on mortality 30 days and 1 year after the prevalence survey date.

Methods: The study was conducted at Haukeland University Hospital, Norway, a large combined emergency and referral teaching hospital, from 2004 to 2011 with follow-up until November 2012. Prevalence of all types of HAIs including urinary tract infections (UTI), lower respiratory tract infections (LRTI), surgical site infections (SSI) and blood stream infections (BSI) were recorded four times every year. Information on the date of birth, admission and discharge from the hospital, number of diagnoses (ICD-10 codes) and patient's mortality was retrieved from the patient administrative data system. The data were analysed by Kaplan-Meier survival analysis and by multiple Cox regression analysis, adjusted for year of registration, time period, sex, type of admission, Charlson comorbidity index, surgical operation, use of urinary tract catheter and time from admission to the prevalence survey date.

Results: The overall prevalence of HAIs was 8.5 % (95 % CI: 8.1, 8.9). Patients with HAIs had an adjusted hazard ratio (HR) of 1.5 (95 % CI: 1.3, 1.8,) and 1.4 (95 % CI: 1.2, 1.5) for death within 30-days and 1 year, relative to those without HAIs. Subgroup analyses revealed that patients with BSI, LRTI or more than one simultaneous infection had an increased risk of death.

Conclusions: In this long time follow-up study, we found that HAIs have severe consequences for the patients. BSI, LRTI and more than one simultaneous infection were independently and strongly associated with increased mortality 30 days and 1 year after inclusion in the study.

No MeSH data available.


Related in: MedlinePlus

Survival of 19,468 patients with and without hospital-associated infections (HAIs)
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Fig2: Survival of 19,468 patients with and without hospital-associated infections (HAIs)

Mentions: By Kaplan-Meier survival analyses we found that patients without HAIs had a 1 year survival of 70 %, compared to 85 % in those without HAIs (p < 0.001). The lowest survival rates were found among patients with LRTI and BSI. Patients with SSI had the same survival rates as those without HAIs (Fig. 2).Fig. 2


Mortality related to hospital-associated infections in a tertiary hospital; repeated cross-sectional studies between 2004-2011.

Koch AM, Nilsen RM, Eriksen HM, Cox RJ, Harthug S - Antimicrob Resist Infect Control (2015)

Survival of 19,468 patients with and without hospital-associated infections (HAIs)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4696323&req=5

Fig2: Survival of 19,468 patients with and without hospital-associated infections (HAIs)
Mentions: By Kaplan-Meier survival analyses we found that patients without HAIs had a 1 year survival of 70 %, compared to 85 % in those without HAIs (p < 0.001). The lowest survival rates were found among patients with LRTI and BSI. Patients with SSI had the same survival rates as those without HAIs (Fig. 2).Fig. 2

Bottom Line: The data were analysed by Kaplan-Meier survival analysis and by multiple Cox regression analysis, adjusted for year of registration, time period, sex, type of admission, Charlson comorbidity index, surgical operation, use of urinary tract catheter and time from admission to the prevalence survey date.Subgroup analyses revealed that patients with BSI, LRTI or more than one simultaneous infection had an increased risk of death.BSI, LRTI and more than one simultaneous infection were independently and strongly associated with increased mortality 30 days and 1 year after inclusion in the study.

View Article: PubMed Central - PubMed

Affiliation: Department of Research and Development, Haukeland University Hospital, Jonas Liesv. 65, 5021 Bergen, Norway ; Department of Clinical Science, University of Bergen, Jonas Liesv. 87, Bergen, Norway.

ABSTRACT

Background: Hospital-associated infections (HAIs) are reported to increase patient mortality and incur longer hospital stays. Most studies to date have focused on specific groups of hospitalised patients with a rather short follow-up period. In this repeated cross-sectional study, with prospective follow-up of 19,468 hospitalized patients, we aimed to analyze the impact of HAIs on mortality 30 days and 1 year after the prevalence survey date.

Methods: The study was conducted at Haukeland University Hospital, Norway, a large combined emergency and referral teaching hospital, from 2004 to 2011 with follow-up until November 2012. Prevalence of all types of HAIs including urinary tract infections (UTI), lower respiratory tract infections (LRTI), surgical site infections (SSI) and blood stream infections (BSI) were recorded four times every year. Information on the date of birth, admission and discharge from the hospital, number of diagnoses (ICD-10 codes) and patient's mortality was retrieved from the patient administrative data system. The data were analysed by Kaplan-Meier survival analysis and by multiple Cox regression analysis, adjusted for year of registration, time period, sex, type of admission, Charlson comorbidity index, surgical operation, use of urinary tract catheter and time from admission to the prevalence survey date.

Results: The overall prevalence of HAIs was 8.5 % (95 % CI: 8.1, 8.9). Patients with HAIs had an adjusted hazard ratio (HR) of 1.5 (95 % CI: 1.3, 1.8,) and 1.4 (95 % CI: 1.2, 1.5) for death within 30-days and 1 year, relative to those without HAIs. Subgroup analyses revealed that patients with BSI, LRTI or more than one simultaneous infection had an increased risk of death.

Conclusions: In this long time follow-up study, we found that HAIs have severe consequences for the patients. BSI, LRTI and more than one simultaneous infection were independently and strongly associated with increased mortality 30 days and 1 year after inclusion in the study.

No MeSH data available.


Related in: MedlinePlus