Title
Factors associated with mortality in critically ill patients diagnosed with hospital acquired infections
Date Issued
2020
Access level
open access
Resource Type
journal article
Author(s)
Otero M.L.
Menezes R.C.
Ferreira I.B.B.
Issa F.L.
Agareno G.
Carmo T.A.
Fukutani K.F.
Neto L.P.
Agareno S.
Filho N.M.F.
Akrami K.M.
Andrade B.B.
Universidade do Estado da Bahia
Publisher(s)
Dove Medical Press Ltd.
Abstract
Objective: Evaluate host and pathogen factors associated with mortality in those with hospital acquired infections (HAI) in a tertiary intensive care unit in Brazil. Methods: Observational and analytical cohort single center study in a general intensive care unit (ICU) in Northeastern Brazil between January 2016 and August 2018, including those over 18 years of age admitted to the ICU found to have a HAI. Results: A total of 165 patients were included, with a mean age of 72 years and male predominance (53.3%) and observed mortality of 46%. Mortality in those with HAI was significantly associated with older age, increased ICU length of stay and readmission to the ICU in univariate analysis. Multivariate analysis revealed that development of septic shock and obtundation during ICU admission was significantly associated with an increased risk of death (OR: 6.94, 95% CI 1.23â39.27, OR: 2.48, 95% CI 1.17â5.29, respectively). A trend towards mortality risk was noted in those with increased age and prior cardiovascular disease. Surprisingly, mortality risk was independent of site of infection, type of pathogen and antibiotic resistance. Furthermore, having more than one HAI over the course of the ICU admission did not impact mortality. Conclusion: Risk of death in those with HAI is associated with obtundation and septic shock, in addition to vasopressor use. Host factors, rather than pathogen-specific characteristics or infecting site, impact risk of death related to HAI in the ICU.
Start page
2811
End page
2817
Volume
13
Language
English
OCDE Knowledge area
Enfermedades infecciosas
Subjects
Scopus EID
2-s2.0-85090374135
Source
Infection and Drug Resistance
ISSN of the container
11786973
Sponsor(s)
The authors thank the research groups GEMINI, from the NĂşcleo de Ensino e Pesquisa from Hospital da Cidade, and MONSTER, Osvaldo Cruz Foundation.The study was supported by the Intramural Research Program from Hospital da Cidade and from the Fundação Oswaldo Cruz. The work of B.B.A. was supported by the the Conselho Nacional de Desenvolvimento CientĂfico e TecnolĂłgico (CNPq; senior scientist fellowship). KFF received a fellowship from the Programa Nacional de PĂłs-Doutorado, Coordenação de Aperfeiçoamento de Pessoal de NĂvel Superior (CAPES, finance code 001). MBA and TAC received research fellowships from Fundação de Amparo Ă Pesquisa do Estado da Bahia (FAPESB). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
The study was supported by the Intramural Research Program from Hospital da Cidade and from the Fundação Oswaldo Cruz. The work of B.B.A. was supported by the the Conselho Nacional de Desenvolvimento CientĂfico e T ecnolĂłgico (CNPq; senior scientist fellowship). KFF received a fellowship from the Programa Nacional de PĂłs-Doutorado, Coordenação de Aperfeiçoamento de Pessoal de NĂvel Superior (CAPES, finance code 001). MBA and T AC received research fellowships from Fundação de Amparo Ă Pesquisa do Estado da Bahia (F APESB). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Sources of information:
Directorio de ProducciĂłn CientĂfica
Scopus