[Dutch results of the European study of the prevalence of infections during intensive care (EPIIC). I. Who is at risk?].

OBJECTIVE

Evaluation of the point prevalence of infections acquired in an intensive care unit (ICU) and determination of risk factors for ICU patients.

DESIGN

Descriptive study.

SETTING

78 Dutch ICUs.

METHOD

Collecting data by detailed questionnaires for each patient admitted to one of the participating ICUs, on one specified day: April 29th, 1992. Follow-up lasted 6 weeks.

RESULTS

Included in the study were 472 patients; 176 (37%) suffered from an infection, of which 74 (16%) was ICU-acquired. The most important risk factors were: a longer ICU stay (relative risk (RR) 4.23 (95% confidence interval: 3.32-5.40), 99.37 (22.26-434.50) and 146.79 (32.83-656.30) for ICU stays of 3-4 days, 1-2 and more than 3 weeks respectively, in comparison with 0-2 days), correlated with severity of disease (organ dysfunction) and more medical interventions (intubation, urine catheter). The ICU infection risk was lower after elective surgery than after ICU admission without surgery; after emergency surgery the ICU infection risk was higher. During follow-up 63 (14%) patients died. Patients suffering from an ICU infection had a higher mortality risk; the strongest prognostic factor in determining the mortality risk was the APACHE II score (RR: 13 (3.89-42.69) with a score between 16-26 and RR > 100 (7.67-1377.93) with score > 31).

CONCLUSION

ICU-acquired infections are a serious problem. Programmes for infection prevention and control need to be adjusted.