Nuffield Health-The Manor Hospital, Oxford, UK.
Independent Researcher, Lisbon, Portugal.
Am J Infect Control. 2017 Oct 1;45(10):e103-e107. doi: 10.1016/j.ajic.2017.03.036. Epub 2017 May 23.
Health care-associated infections (HCAIs) are preventable with adoption of recognized preventive measures. The first step is to identify patients at higher risk of HCAI. This study aimed to identify patient risk factors (RFs) present on admission and acquired during inpatient stay which could be associated with higher risk of acquiring HCAI.
A case-control study was conducted in adult patients admitted during 2011 who were hospitalized for >48 hours. Cases were patients with HCAIs. Controls were selected in a ratio of 3:1, case matched by the admission date. The likelihood of increased HCAI was determined through binary logistic regression.
RFs identified as being the more relevant for HCAI were being a man (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.7), being aged >50 years (OR, 2.9; 95% CI, 1.3-6.9), and having an insertion of a central venous line during hospital stay (OR, 12.4; 95% CI, 5.0-30.5).
RFs that showed statistical significance on admission were the patient's intrinsic factors, and RFs acquired during hospitalization were extrinsic RFs. When a set of RFs were present, the presence of a central venous line proved to be the more relevant one.
通过采用公认的预防措施,可以预防与医疗保健相关的感染(HAI)。第一步是确定感染 HAI 风险较高的患者。本研究旨在确定入院时和住院期间获得的与更高的 HAI 风险相关的患者风险因素(RFs)。
对 2011 年期间住院时间超过 48 小时的成年患者进行病例对照研究。病例为患有 HAI 的患者。对照组按照入院日期以 3:1 的比例选择。通过二项逻辑回归确定 HCAI 风险增加的可能性。
被确定为与 HCAI 更相关的 RFs 是男性(比值比 [OR],2.4;95%置信区间 [CI],1.2-4.7)、年龄 >50 岁(OR,2.9;95% CI,1.3-6.9)和住院期间插入中心静脉导管(OR,12.4;95% CI,5.0-30.5)。
入院时具有统计学意义的 RFs 是患者的内在因素,住院期间获得的 RFs 是外在 RFs。当一组 RFs 存在时,中心静脉导管的存在被证明是更相关的因素。