Estimating attributable mortality due to nosocomial infections acquired in intensive care units.

Détails

Ressource 1Télécharger: BIB_373C7CC8F85C.P001.pdf (75.82 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_373C7CC8F85C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Estimating attributable mortality due to nosocomial infections acquired in intensive care units.
Périodique
Infection Control and Hospital Epidemiology
Auteur(s)
Januel Jean-Marie, Harbarth Stephan, Allard Robert, Voirin Nicolas, Lepape Alain, Allaouchiche Bernard, Guerin Claude, Lehot Jean-Jacques, Robert Marc-Olivier, Fournier Gérard, Jacques Didier, Chassard Dominique, Gueugniaud Pierre-Yves, Artru François, Petit Paul, Robert Dominique, Mohammedi Ismaël, Girard Raphaëlle, Cêtre Jean-Charles, Nicolle Marie-Christine, Grando Jacqueline, Fabry Jacques, Vanhems Philippe
ISSN
1559-6834[electronic], 0899-823X[linking]
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
31
Numéro
4
Pages
388-394
Langue
anglais
Résumé
BACKGROUND: The strength of the association between intensive care unit (ICU)-acquired nosocomial infections (NIs) and mortality might differ according to the methodological approach taken. OBJECTIVE: To assess the association between ICU-acquired NIs and mortality using the concept of population-attributable fraction (PAF) for patient deaths caused by ICU-acquired NIs in a large cohort of critically ill patients. SETTING: Eleven ICUs of a French university hospital. DESIGN: We analyzed surveillance data on ICU-acquired NIs collected prospectively during the period from 1995 through 2003. The primary outcome was mortality from ICU-acquired NI stratified by site of infection. A matched-pair, case-control study was performed. Each patient who died before ICU discharge was defined as a case patient, and each patient who survived to ICU discharge was defined as a control patient. The PAF was calculated after adjustment for confounders by use of conditional logistic regression analysis. RESULTS: Among 8,068 ICU patients, a total of 1,725 deceased patients were successfully matched with 1,725 control patients. The adjusted PAF due to ICU-acquired NI for patients who died before ICU discharge was 14.6% (95% confidence interval [CI], 14.4%-14.8%). Stratified by the type of infection, the PAF was 6.1% (95% CI, 5.7%-6.5%) for pulmonary infection, 3.2% (95% CI, 2.8%-3.5%) for central venous catheter infection, 1.7% (95% CI, 0.9%-2.5%) for bloodstream infection, and 0.0% (95% CI, -0.4% to 0.4%) for urinary tract infection. CONCLUSIONS: ICU-acquired NI had an important effect on mortality. However, the statistical association between ICU-acquired NI and mortality tended to be less pronounced in findings based on the PAF than in study findings based on estimates of relative risk. Therefore, the choice of methods does matter when the burden of NI needs to be assessed.
Mots-clé
Case-Control Studies, Cause of Death, Critical Illness, Cross Infection/epidemiology, Cross Infection/mortality, France, Hospital Mortality/trends, Hospitals, University, Humans, Incidence, Intensive Care Units/statistics & numerical data, Length of Stay, Population Surveillance/methods, Risk
Pubmed
Web of science
Création de la notice
30/06/2010 9:56
Dernière modification de la notice
03/03/2018 16:04
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