The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: A case-control study

Barnett, Adrian G., Page, Katie, Campbell, Megan, Martin, Elizabeth, Rashleigh-Rolls, Rebecca, Halton, Kate, Paterson, David L, Hall, Lisa, Jimmieson, Nerina L., White, Katherine M., & Graves, Nicholas (2013) The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: A case-control study. BMJ Open, 3, Article number-e003587.

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Abstract

Objectives

  • Hospital-acquired bloodstream infections are known to increase the risk of death and prolong hospital stay, but precise estimates of these two important outcomes from well-designed studies are rare, particularly for non-intensive care unit (ICU) patients. We aimed to calculate accurate estimates, which are vital for estimating the economic costs of hospital-acquired bloodstream infections.

Design

  • Case–control study.

Setting

  • 9 Australian public hospitals.

Participants

  • All the patients were admitted between 2005 and 2010.

Primary and secondary outcome measures

  • Risk of death and extra length of hospital stay associated with nosocomial infection.

Results

  • The greatest increase in the risk of death was for a bloodstream infection with methicillin-resistant Staphylococcus aureus (HR=4.6, 95% CI 2.7 to 7.6). This infection also had the longest extra length of stay to discharge in a standard bed (12.8 days, 95% CI 6.2 to 26.1 days). All the eight bloodstream infections increased the length of stay in the ICU, with longer stays for the patients who eventually died (mean increase 0.7–6.0 days) compared with those who were discharged (mean increase: 0.4–3.1 days). The three most common organisms associated with Gram-negative infection were Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia.

Conclusions

  • Bloodstream infections are associated with an increased risk of death and longer hospital stay. Avoiding infections could save lives and free up valuable bed days.

Impact and interest:

15 citations in Scopus
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12 citations in Web of Science®

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ID Code: 63920
Item Type: Journal Article
Refereed: Yes
Keywords: hospital, intensive care, infection, nosocomial
DOI: 10.1136/bmjopen-2013-003587
ISSN: 2044-6055
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Divisions: Current > QUT Faculties and Divisions > QUT Business School
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
Current > Schools > School of Public Health & Social Work
Funding:
Copyright Owner: 2013 The Author(s)
Copyright Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
Deposited On: 04 Nov 2013 04:15
Last Modified: 16 Dec 2016 04:40

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