Abhishek Chintamani, Prakash Bala, Abraham Babu K, Kumar Senthil, Ramakrishnan Nagarajan, Venkataraman Ramesh
Department of Critical Care, Apollo Hospitals, Chennai, Tamil Nadu, India.
Indian J Crit Care Med. 2021 Mar;25(3):292-295. doi: 10.5005/jp-journals-10071-23760.
To compare the incidence of healthcare-associated infections (HAI) and their outcomes between patients admitted to the ICU with sepsis and those admitted with non-sepsis diagnoses. We performed a single-center, prospective, observational study of ICU patients at a tertiary level medical-surgical unit from April 2018 to October 2018. All patients admitted to the ICU with a length of stay (LOS) > 48 hours were included. Baseline data including demographics, comorbidities, and severity of illness scores were collected. Index occurrence of HAI in all these patients was noted and data regarding organ support and patient outcomes were recorded. The incidence, complications, ICU LOS, and 30-day mortality of HAI were compared between the patients admitted to ICU originally with sepsis and non-sepsis diagnoses. A total of 271 patients were evaluated in our study ( = 106 for the sepsis group and = 165 for the non-sepsis group). No significant difference between the groups was found in the incidence of HAI (29.2% in sepsis group vs 24.4% in non-sepsis group; = 0.07). Complications (acute kidney injury (AKI): 71 vs 45%; = 0.01, shock: 81 vs 55%; = 0.05, need for mechanical ventilation (MV): 30 vs 15%; = 0.04) were more common in sepsis group compared to the non-sepsis group. The ICU LOS (12.2 ± 5.2 days vs 8.8 ± 2.05 days; = 0.01) was significantly longer in the sepsis group. There was no significant difference in 30-day mortality between the groups (45 vs 25%; = 0.07). The incidence of HAI seems to be similar between patients admitted with sepsis and non-sepsis diagnoses. However, patients admitted with sepsis develop higher rates of organ failure secondary to HAI and have a longer ICU LOS compared to patients admitted with non-sepsis diagnoses. The mortality rate of HAI did not differ between these two groups. Chintamani A, Prakash B, Abraham BK, Kumar S, Ramakrishnan N, Venkataraman R. Incidence and Impact of Healthcare-associated Infections on Patients Primarily Admitted with Sepsis and Non-sepsis Diagnoses. Indian J Crit Care Med 2021;25(3): 292-295.
比较入住重症监护病房（ICU）的脓毒症患者与非脓毒症诊断患者的医疗相关感染（HAI）发生率及其转归。我们于2018年4月至2018年10月在一家三级综合内科-外科病房对ICU患者进行了一项单中心、前瞻性观察性研究。纳入所有入住ICU且住院时间（LOS）>48小时的患者。收集包括人口统计学、合并症和疾病严重程度评分在内的基线数据。记录所有这些患者HAI的首次发生情况，并记录有关器官支持和患者转归的数据。比较最初入住ICU的脓毒症患者与非脓毒症诊断患者之间HAI的发生率、并发症、ICU住院时间和30天死亡率。我们的研究共评估了271例患者（脓毒症组106例，非脓毒症组165例）。两组之间HAI发生率无显著差异（脓毒症组为29.2%，非脓毒症组为24.4%；P=0.07）。与非脓毒症组相比，脓毒症组并发症（急性肾损伤（AKI）：71%对45%；P=0.01，休克：81%对55%；P=0.05，需要机械通气（MV）：30%对15%；P=0.04）更常见。脓毒症组的ICU住院时间显著更长（12.2±5.2天对8.8±2.05天；P=0.01）。两组之间30天死亡率无显著差异（45%对25%；P=0.07）。脓毒症诊断患者与非脓毒症诊断患者的HAI发生率似乎相似。然而，与非脓毒症诊断患者相比，脓毒症诊断患者继发于HAI的器官衰竭发生率更高，ICU住院时间更长。这两组患者的HAI死亡率无差异。钦塔马尼A，普拉卡什B，亚伯拉罕BK，库马尔S，拉马克里什南N，文卡塔拉曼R。医疗相关感染对主要因脓毒症和非脓毒症诊断入院患者的发生率及影响。《印度重症监护医学杂志》2021年；25（3）：292 - 295。
