The impact of healthcare-associated infections on mortality in ICU: a prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East

Rosenthal, Victor Daniel and Yin, Ruijie and Lu, Yawen and Rodrigues, Camilla and Myatra, Sheila Nainan and Kharbanda, Mohit and Valderrama-Beltran, Sandra Liliana and Mehta, Yatin and Daboor, Mohammad Abdellatif and Todi, Subhash Kumar and Aguirre-Avalos, Guadalupe and Guclu, Ertugrul and Gan, Chin Seng and Jiménez-Alvarez, Luisa Fernanda and Chawla, Rajesh and Hlinkova, Sona and Arjun, Rajalakshmi and Agha, Hala Mounir and Zuniga-Chavarria, Maria Adelia and Davaadagva, Narangarav and Mat Nor, Mohd Basri and Gomez-Nieto, Katherine and Aguilar-de-Moros, Daisy and Tai, Chian-Wern and Sassoe-Gonzalez, Alejandro (2023) The impact of healthcare-associated infections on mortality in ICU: a prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East. American Journal of Infection Control, 51 (6). pp. 675-682. ISSN 01966553

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Abstract

Background: The International Nosocomial Infection Control Consortium has found a high ICU mortality rate. Our aim was to identify all-cause mortality risk factors in ICU-patients. Methods: Multinational, multicenter, prospective cohort study at 786 ICUs of 312 hospitals in 147 cities in 37 Latin American, Asian, African, Middle Eastern, and European countries. Results: Between 07/01/1998 and 02/12/2022, 300,827 patients, followed during 2,167,397 patient-days, acquired 21,371 HAIs. Following mortality risk factors were identified in multiple logistic regression: Central line-associated bloodstream infection (aOR:1.84; P<.0001); ventilator-associated pneumonia (aOR:1.48; P<.0001); catheter-associated urinary tract infection (aOR:1.18;P<.0001); medical hospitalization (aOR:1.81; P<.0001); length of stay (LOS), risk rises 1% per day (aOR:1.01; P<.0001); female gender (aOR:1.09; P<.0001); age (aOR:1.012; P<.0001); central line-days, risk rises 2% per day (aOR:1.02; P<.0001); and mechanical ventilator (MV)-utilization ratio (aOR:10.46; P<.0001). Coronary ICU showed the lowest risk for mortality (aOR: 0.34;P<.0001). Conclusion: Some identified risk factors are unlikely to change, such as country income-level, facility ownership, hospitalization type, gender, and age. Some can be modified; Central line-associated bloodstream infection, ventilator-associated pneumonia, catheter-associated urinary tract infection, LOS, and MV-utilization. So, to lower the risk of death in ICUs, we recommend focusing on strategies to shorten the LOS, reduce MVutilization, and use evidence-based recommendations to prevent HAIs.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Risk factor Hospital infections Nosocomial infections Intensive care unit Worldwide Multiple Logistic Regression
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	01 Nov 2024 11:40
Last Modified:	01 Nov 2024 11:40
URI:	http://irep.iium.edu.my/id/eprint/115450

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