Sánchez-Velázquez Luis D, Ponce de León Rosales Samuel, Rangel Frausto M Sigfrido
Unidad de Investigación Médica en Epidemiología Hospitalaria, Centro Médico Nacional Siglo XXI, IMSS, México, D.F., México.
Arch Med Res. 2006 Apr;37(3):370-5. doi: 10.1016/j.arcmed.2005.07.004.
Nosocomial infections increase mortality and costs in the intensive care units; however, few studies have addressed organ failure that developed in infected patients and their overall costs. The goal of this study was to measure the frequency of organ failure in nosocomial infection and the mortality and costs of these in critical care areas.
This was a nested 1:2 case-control study in a cohort of all consecutively hospitalized patients comparing those with and without nosocomial infections over a year in an institutional intensive care unit (ICU). Those patients who acquired an infection during hospitalization were considered cases. Controls were matched by hospital stay at least as long as the cases' time acquisition of nosocomial infection, age +/-5 years and APACHE II +/-5 points.
Forty-three patients developed at least one nosocomial infection event (cases). The matching success was about 94%. Higher frequency and duration of organ failures was observed in the cases, as well as the number of devices and procedures (p < 0.05). Attributable mortality was 16.3% (p < 0.001). Attributable total cost of a nosocomial infection acquired in the ICU was 12,155 dollars.
Nosocomial infection acquired in the ICU increases length of stay, frequency and duration of organ failures, mortality, and costs.
医院感染会增加重症监护病房的死亡率和成本；然而，很少有研究涉及感染患者出现的器官衰竭及其总体成本。本研究的目的是测量医院感染中器官衰竭的发生率以及重症监护区域中这些感染的死亡率和成本。
这是一项嵌套的1:2病例对照研究，在一个机构重症监护病房（ICU）中，对所有连续住院一年的患者队列进行研究，比较有医院感染和无医院感染的患者。那些在住院期间获得感染的患者被视为病例。对照组在住院时间上至少与病例获得医院感染的时间相同，年龄相差±5岁，急性生理与慢性健康状况评分系统II（APACHE II）相差±5分。
43名患者发生了至少一次医院感染事件（病例）。匹配成功率约为94%。病例组中观察到器官衰竭的频率和持续时间更高，以及设备和操作的数量更多（p < 0.05）。归因死亡率为16.3%（p < 0.001）。在ICU获得的医院感染的归因总成本为12,155美元。
在ICU获得的医院感染会增加住院时间、器官衰竭的频率和持续时间、死亡率以及成本。
