Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Intensive Care Unit, Aviation General Hospital of China Medical University, Beijing, China.
Front Public Health. 2022 Jun 24;10:857873. doi: 10.3389/fpubh.2022.857873. eCollection 2022.
This study conducts a meta-analysis of clinical outcomes of nosocomial infection in adult patients receiving extracorporeal membrane oxygenation (ECMO) and systematically evaluates clinical epidemiological characteristics.
Document retrieval strategies were determined, and all adult patients treated by ECMO were included. The prevalence, incidence, mortality, ECMO use time, intensive care unit (ICU) stay time, hospital stay time, and risk factors of nosocomial infection were systematically evaluated. Subsequently, a meta-analysis of the impact of nosocomial infection on risk of in-hospital mortality was conducted.
A total of 25 retrospective studies were included, and 19 studies were included in the meta-analysis. The prevalence of nosocomial infection was 8.8-64.0%, incidence was 1.7-85.4‰ (per 1,000 ECMO days), and in-hospital mortality was 31.5-75.4%. The duration of ECMO usage and length of ICU stay were longer for infected patients. Compared with non-infected patients, the meta-analysis revealed that nosocomial infection increased the relative risk of death of adult patients receiving ECMO by 32%. The risk factors included the duration of ECMO usage and disease severity score.
Adult patients treated by ECMO have high prevalence of nosocomial infection. In addition, their ECMO use time and ICU stays are longer. Nosocomial infection significantly increases the relative risk of in-hospital mortality.
本研究对接受体外膜肺氧合（ECMO）治疗的成年患者的医院感染临床结局进行荟萃分析，系统评价其临床流行病学特征。
确定文献检索策略，纳入所有接受 ECMO 治疗的成年患者。系统评估医院感染的患病率、发病率、死亡率、ECMO 使用时间、重症监护病房（ICU）入住时间、住院时间和感染危险因素。随后，对医院感染对住院死亡率风险的影响进行荟萃分析。
共纳入 25 项回顾性研究，其中 19 项研究纳入荟萃分析。医院感染的患病率为 8.8%-64.0%，发病率为 1.7-85.4‰（每 1000 个 ECMO 天），住院死亡率为 31.5%-75.4%。感染患者的 ECMO 使用时间和 ICU 入住时间更长。与非感染患者相比，荟萃分析显示医院感染使接受 ECMO 治疗的成年患者的死亡相对风险增加了 32%。危险因素包括 ECMO 使用时间和疾病严重程度评分。
接受 ECMO 治疗的成年患者医院感染患病率较高，且 ECMO 使用时间和 ICU 入住时间更长。医院感染显著增加了住院死亡率的相对风险。
