Clinical and economic impact of intensive care unit-acquired bloodstream infections in Taiwan: a nationwide population-based retrospective cohort study

ObjectivesTo estimate the clinical and economic impact of intensive care unit-acquired bloodstream infections in Taiwan.DesignRetrospective cohort study.SettingNationwide Taiwanese population in the National Health Insurance Research Database and the Taiwan Nosocomial Infections Surveillance (2007–2015) dataset.ParticipantsThe first episodes of intensive care unit-acquired bloodstream infections in patients ≥20 years of age in the datasets. Propensity score-matching (1:2) of demographic data, comorbidities and disease severity was performed to select a comparison cohort from a pool of intensive care unit patients without intensive care unit-acquired infections from the same datasets.Primary and secondary outcome measuresThe mortality rate, length of hospitalisation and healthcare cost.ResultsAfter matching, the in-hospital mortality of 14 234 patients with intensive care unit-acquired bloodstream infections was 44.23%, compared with 33.48% for 28 468 intensive care unit patients without infections. The 14-day mortality rate was also higher in the bloodstream infections cohort (4323, 30.37% vs 6766 deaths, 23.77%, respectively; p<0.001). Furthermore, the patients with intensive care unit-acquired bloodstream infections had a prolonged length of hospitalisation after their index date (18 days (IQR 7–39) vs 10 days (IQR 4–21), respectively; p<0.001) and a higher healthcare cost (US$16 038 (IQR 9667–25 946) vs US$10 372 (IQR 6289–16 932), respectively; p<0.001). The excessive hospital stay and healthcare cost per case were 12.69 days and US$7669, respectively. Similar results were observed in subgroup analyses of various WHO’s priority pathogens and Candida spp.ConclusionsIntensive care unit-acquired bloodstream infections in critically ill patients were associated with increased mortality, longer hospital stays and higher healthcare costs.

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Survival and Predictors of Mortality Among Patients Admitted to Intensive Care Unit in Southern Ethiopia: A Multi-center Retrospective Cohort Study

10.21203/rs.3.rs-97694/v1 ◽

2020 ◽

Author(s):

semagn Mekonnen Abate ◽

Sofia Assen ◽

Mengistu Yinges ◽

Bivash Basu

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Mortality Rate ◽

Low Income ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Southern Ethiopia ◽

Icu Mortality ◽

Predictors Of Mortality

Abstract Background: The burden of life-threatening conditions requiring intensive care unit has grown substantially in low-income countries related to an emerging pandemic, urbanization, and hospital expansion. The rate of ICU mortality is varied from region to region in Ethiopia. However, body of evidence on ICU mortality and its predictors is uncertain. This study was designed to investigate the pattern of disease and predictors of mortality in Southern Ethiopia.Methods: After obtaining Ethical clearance from institutional Review Board (IRB), a multi-center retrospective Cohort study was conducted among three teaching referral hospital ICUs of southern Ethiopia from June, 2018 to May, 2020. Five hundred and seventeen Adult ICU patients were selected. Data were entered in Statistical Package for Social Sciences version 22 and STATA version 16 for analysis. Descriptive statistics were run to see the overall distribution of the variables. Chi square test and odds ratio were determine to identify the association between independent and dependent variables. Multivariate analysis was conducted to control possible confounders and identify independent predictors of ICU mortality.Results: The mean (± SD) of the patients admitted in ICU was 34.25(±5.25). The overall ICU mortality rate was 46.8%. The study identified different independent predictors of mortality. Patients with cardiac arrest were approximately 12 times more likely to die as compared to who didn’t, AOR=11.9 (95% CI:6.1 to 23.2).Conclusion: The overall mortality rate in ICU was very high as compared to other studies in Ethiopia as well as globally which entails a rigorous activity from different stakeholders.

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