MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
Int J Environ Res Public Health. 2021 Apr 28;18(9):4703. doi: 10.3390/ijerph18094703.
Hospital-Acquired Infections (HAIs) represent the most frequent adverse event associated with healthcare delivery and result in prolonged hospital stays and deaths worldwide.
To analyze the spatial patterns of HAI incidence from 2014 to 2017 in Portugal.
Data from the Portuguese Discharge Hospital Register were used. We selected episodes of patients with no infection on admission and with any of the following HAI diagnoses: catheter-related bloodstream infections, intestinal infections by , nosocomial pneumonia, surgical site infections, and urinary tract infections. We calculated age-standardized hospitalization rates (ASHR) by place of patient residence. We used empirical Bayes estimators to smooth the ASHR. The Moran Index and Local Index of Spatial Autocorrelation (LISA) were calculated to identify spatial clusters.
A total of 318,218 HAIs were registered, with men accounting for 49.8% cases. The median length of stay (LOS) was 9.0 days, and 15.7% of patients died during the hospitalization. The peak of HAIs ( = 81,690) occurred in 2015, representing 9.4% of the total hospital admissions. Substantial spatial inequalities were observed, with the center region presenting three times the ASHR of the north. A slight decrease in ASHR was observed after 2015. Pneumonia was the most frequent HAI in all age groups.
The incidence of HAI is not randomly distributed in the space; clusters of high risk in the central region were seen over the entire study period. These findings may be useful to support healthcare policymakers and to promote a revision of infection control policies, providing insights for improved implementation.
医院获得性感染（HAI）是与医疗保健相关的最常见的不良事件，导致全球住院时间延长和死亡。
分析 2014 年至 2017 年葡萄牙 HAI 发病率的空间模式。
使用葡萄牙出院医院登记处的数据。我们选择了入院时无感染且有以下任何 HAI 诊断的患者的病例：导管相关血流感染、肠道感染、医院获得性肺炎、手术部位感染和尿路感染。我们按患者居住地计算了年龄标准化住院率（ASHR）。我们使用经验贝叶斯估计量对 ASHR 进行平滑处理。计算了 Moran 指数和局部空间自相关指数（LISA）以识别空间聚类。
共登记了 318218 例 HAI，其中男性占 49.8%。中位住院时间（LOS）为 9.0 天，15.7%的患者在住院期间死亡。HAI 高峰（=81690）发生在 2015 年，占总住院人数的 9.4%。观察到明显的空间不平等，中心区域的 ASHR 是北部的三倍。2015 年后，ASHR 略有下降。肺炎是所有年龄组中最常见的 HAI。
HAI 的发病率在空间上不是随机分布的；在整个研究期间，中心区域都存在高风险的集群。这些发现可能有助于支持医疗保健政策制定者，并促进感染控制政策的修订，为改进实施提供见解。
