Risk factors for mortality in ICU patients in 10 middle eastern countries: The role of healthcare-associated infections.
J Crit Care
; 72: 154149, 2022 12.
Article
em En
| MEDLINE
| ID: mdl-36108349
ABSTRACT
PURPOSE:
The International Nosocomial Infection Control Consortium (INICC) found a high mortality rate in ICUs of the Middle East (ME). Our goal was to identify mortality risk factor (RF) in ICUs of the ME. MATERIALS From 08/01/2003 to 02/12/2022, we conducted a prospective cohort study in 236 ICUs of 77 hospitals in 44 cities in 10 countries of ME. We analyzed 16 independent variables using multiple logistic regression.RESULTS:
66,440 patients, hospitalized during 652,167 patient-days, and 13,974 died. We identified following mortality RF Age (adjusted odds ratio (aOR)1.02;p < 0.0001) rising risk 2% yearly; length of stay (LOS) (aOR1.02;p < 0.0001) rising the risk 2% per day; central line (CL)-days (aOR1.01;p < 0.0001) rising risk 1% per day; mechanicalventilator (MV) utilization-ratio (aOR14.51;p < 0.0001); CL-associated bloodstream infection (CLABSI) acquisition (aOR)1.49;p < 0.0001); ventilator-associated pneumonia (VAP) acquisition (aOR1.50;p < 0.0001); female gender (OR1.14;p < 0.0001); hospitalization at a public-hospital (OR1.31;p < 0.0001); and medical-hospitalization (aOR1.64;p < 0.0001). High-income countries showed lowest risk (aOR0.59;p < 0.0001).CONCLUSION:
Some identified RF are unlikely to change, such as country income-level, facility ownership, hospitalization type, gender, and age. Some can be modified; LOS, CL-use, MV-use, CLABSI, VAP. So, to lower the mortality risk in ICUs, we recommend focusing on strategies to shorten the LOS, reduce CL and MV-utilization, and use evidence-based recommendations to prevent CLABSI and VAP.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecção Hospitalar
/
Pneumonia Associada à Ventilação Mecânica
/
Infecções Relacionadas a Cateter
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
J Crit Care
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2022
Tipo de documento:
Article