Publication
The impact of healthcare-associated infections on mortality in ICU: A prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East
Publisher:
Elsevier BV
Date:
06-2023
DOI:
10.1016/J.AJIC.2022.08.024
Abstract: 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. 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. 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). 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 MV-utilization, and use evidence-based recommendations to prevent HAIs.