Intensive Care Acquired Infection is an Independent Risk Factor for Hospital Mortality: a Prospective Cohort Study

Overview

Journal Crit Care

Specialty Critical Care

Date 2006 Apr 22

PMID 16626503

Citations 34

Authors

Pekka Ylipalosaari

Tero I Ala-Kokko

Jouko Laurila

Pasi Ohtonen

Hannu Syrjala

Affiliations

Soon will be listed here.

Abstract

Introduction: The aim of this study was to elucidate the impact of intensive care unit (ICU)-acquired infection on hospital mortality.

Methods: Patients with a longer than 48 hour stay in a mixed 10 bed ICU in a tertiary-level teaching hospital were prospectively enrolled between May 2002 and June 2003. Risk factors for hospital mortality were analyzed with a logistic regression model.

Results: Of 335 patients, 80 developed ICU-acquired infection. Among the patients with ICU-acquired infections, hospital mortality was always higher, regardless of whether or not the patients had had infection on admission (infection on admission group (IAG), 35.6% versus 17%, p = 0.008; and no-IAG, 25.7% versus 6.1%, p = 0.023). In IAG (n = 251), hospital stay was also longer in the presence of ICU-acquired infection (median 31 versus 16 days, p < 0.001), whereas in no-IAG (n = 84), hospital stay was almost identical with and without the presence of ICU-acquired infection (18 versus 17 days). In univariate analysis, the significant risk factors for hospital mortality were: Acute Physiology and Chronic Health Evaluation (APACHE) II score >20, sequential organ failure assessment (SOFA) score >8, ICU-acquired infection, age > or = 65, community-acquired pneumonia, malignancy or immunosuppressive medication, and ICU length of stay >5 days. In multivariate logistic regression analysis, ICU-acquired infection remained an independent risk factor for hospital mortality after adjustment for APACHE II score and age (odds ratio (OR) 4.0 (95% confidence interval (CI): 2.0-7.9)) and SOFA score and age (OR 2.7 (95% CI: 2.9-7.6)).

Conclusion: ICU-acquired infection was an independent risk factor for hospital mortality even after adjustment for the APACHE II or SOFA scores and age.

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