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BMJ Open. 2013 Oct 31;3(10):e003587. doi: 10.1136/bmjopen-2013-003587.

The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: a case-control study.

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  • 1Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.

Abstract

OBJECTIVES:

Hospital-acquired bloodstream infections are known to increase the risk of death and prolong hospital stay, but precise estimates of these two important outcomes from well-designed studies are rare, particularly for non-intensive care unit (ICU) patients. We aimed to calculate accurate estimates, which are vital for estimating the economic costs of hospital-acquired bloodstream infections.

DESIGN:

Case-control study.

SETTING:

9 Australian public hospitals.

PARTICIPANTS:

All the patients were admitted between 2005 and 2010.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Risk of death and extra length of hospital stay associated with nosocomial infection.

RESULTS:

The greatest increase in the risk of death was for a bloodstream infection with methicillin-resistant Staphylococcus aureus (HR=4.6, 95% CI 2.7 to 7.6). This infection also had the longest extra length of stay to discharge in a standard bed (12.8 days, 95% CI 6.2 to 26.1 days). All the eight bloodstream infections increased the length of stay in the ICU, with longer stays for the patients who eventually died (mean increase 0.7-6.0 days) compared with those who were discharged (mean increase: 0.4-3.1 days). The three most common organisms associated with Gram-negative infection were Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia.

CONCLUSIONS:

Bloodstream infections are associated with an increased risk of death and longer hospital stay. Avoiding infections could save lives and free up valuable bed days.

KEYWORDS:

General Medicine (see Internal Medicine); Infectious Diseases; Intensive & Critical Care

PMID:
24176795
[PubMed]
PMCID:
PMC3816236
Free PMC Article
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