佛罗里达州住院 ST 段抬高型心肌梗死患者主要感染和不良结局的发生率。2006 年。
Prevalence of major infections and adverse outcomes among hospitalized. ST-elevation myocardial infarction patients in Florida, 2006.
机构信息
Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B, Downs Blvd., Tampa, FL 33612, USA.
出版信息
BMC Cardiovasc Disord. 2011 Nov 22;11:69. doi: 10.1186/1471-2261-11-69.
BACKGROUND
ST-elevation myocardial infarction (STEMI) patients have risk factors and co-morbidities and require procedures predisposing to healthcare acquired infections (HAIs). As few data exist on the extent and consequences of infections among these patients, the prevalence, predictors, and potential complications of major infections among hospitalized STEMI patients at all Florida acute care hospitals during 2006 were analyzed.
METHODS
Sociodemographic characteristics, risk factors, co-morbidities, procedures, complications, and mortality were analyzed from hospital discharge data for 11, 879 STEMI patients age ≥ 18 years. We used multivariable logistic regression modeling to examine and adjust for multiple potential predictors of any infection, bloodstream infection (BSI), pneumonia, surgical site infection (SSI), and urinary tract infection (UTI).
RESULTS
There were 2,562 infections among 16.6% of STEMI patients; 6.2% of patients had ≥2 infections. The most prevalent HAIs were UTIs (6.0%), pneumonia (4.6%), SSIs (4.1%), and BSIs (2.6%). Women were at 29% greater risk, Blacks had 23% greater risk, and HAI risk increased 11% with each 5 year increase in age. PCI was the only protective major procedure (OR 0.81, 95% CI, 0.69-0.95, p < .05). HAI lengthened hospital stays. STEMI patients with a BSI were almost 5 times more likely (31.3% vs. 6.5%, p < .0001), and those with pneumonia were 3 times more likely (19.6% vs. 6.5%, p < .0001) to die before discharge.
CONCLUSIONS
The protective effect of PCI on risk of infection is likely mediated by its many benefits, including reduced length of hospitalizations.
背景
ST 段抬高型心肌梗死（STEMI）患者存在多种风险因素和合并症，并且需要接受可能导致医源性感染（HAI）的治疗。由于关于这些患者感染的程度和后果的数据很少，因此分析了 2006 年所有佛罗里达州急性护理医院住院 STEMI 患者中严重感染的发生率、预测因素和潜在并发症。
方法
从 11879 名年龄≥18 岁的 STEMI 患者的出院数据中分析了社会人口统计学特征、风险因素、合并症、治疗方法、并发症和死亡率。我们使用多变量逻辑回归模型来检查和调整任何感染、血流感染（BSI）、肺炎、手术部位感染（SSI）和尿路感染（UTI）的多个潜在预测因素。
结果
在 16.6%的 STEMI 患者中发生了 2562 例感染；6.2%的患者发生了≥2 次感染。最常见的 HAI 是 UTI（6.0%）、肺炎（4.6%）、SSI（4.1%）和 BSI（2.6%）。女性感染风险增加 29%，黑人感染风险增加 23%，年龄每增加 5 年，感染风险增加 11%。PCI 是唯一具有保护作用的主要治疗方法（OR 0.81，95%CI，0.69-0.95，p <.05）。HAI 延长了住院时间。发生 BSI 的 STEMI 患者几乎有 5 倍（31.3% vs. 6.5%，p <.0001），发生肺炎的患者有 3 倍（19.6% vs. 6.5%，p <.0001）更有可能在出院前死亡。
结论
PCI 对感染风险的保护作用可能是通过其许多益处介导的，包括缩短住院时间。
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