Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit
| Main Author: | |
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| Publication Date: | 2014 |
| Other Authors: | , , , , |
| Format: | Article |
| Language: | eng |
| Source: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Download full: | http://hdl.handle.net/10362/149802 |
Summary: | Funding Information: Financial support: this work was supported by an unrestricted grant from GIS (Grupo de Infecção e Sepsis, Hospital de São João, Porto, Portugal). Publisher Copyright: © 2014 European Society of Clinical Microbiology and Infectious Diseases2012 December 2014 10.1111/1469-0691.12738 Original Article INFECTIOUS DISEASES Original Articles © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases. |
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Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care UnitThe INFAUCI studyAntibioticsEpidemiologyInfectionIntensive Care UnitOutcomeProcess of careMicrobiology (medical)Infectious DiseasesSDG 3 - Good Health and Well-beingFunding Information: Financial support: this work was supported by an unrestricted grant from GIS (Grupo de Infecção e Sepsis, Hospital de São João, Porto, Portugal). Publisher Copyright: © 2014 European Society of Clinical Microbiology and Infectious Diseases2012 December 2014 10.1111/1469-0691.12738 Original Article INFECTIOUS DISEASES Original Articles © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.A prospective, cohort, clinical, observational study was performed in 14 Intensive Care Units (ICUs) to evaluate the contemporary epidemiology, morbi-mortality and determinants of outcome of the population with an infection on admission. All 3766 patients admitted during a consecutive 12-month period were screened. Their median age was 63 [26-83], 61.1% were male and 69.8% had significant comorbidities. On admission to the ICU 1652 patients (43.9%) had an infection, which was community acquired in 68.2% (one-fifth with healthcare-associated criteria) and ward-acquired in the others. Roughly half presented to the ICU with septic shock. As much as 488 patients with community-acquired infections were deemed stable enough to be first admitted to the ward, but had similar mortality to unstable patients directly admitted to the ICU (35.9% vs. 35.1%, p 0.78). Only 48.3% of this infected population had microbiological documentation and almost one-quarter received inappropriate initial antibiotic therapy. This, along with comorbidities, was a main determinant of mortality. Overall, infected patients on admission had higher mortality both in the ICU (28.0% vs. 19.9%, p <0.001) and in the hospital (38.2% vs. 27.5%, p <0.001) and even after being discharged to the ward (14.2% vs. 9.6%, p <0.001). Also, patients not infected on admission who acquired an infection in the ICU, had an increased risk of dying in the hospital (odds ratio 1.41 [1.12-1.83]). Consequently, infection, regardless of its place of acquisition, was associated with increased mortality. Improving the process of care, especially first-line antibiotic appropriateness, and preventing ICU-acquired infections, may lead to better outcomes.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNGonçalves-Pereira, J.Pereira, J. M.Ribeiro, O.Baptista, J. P.Froes, F.Paiva, J. A.2023-02-27T22:23:53Z2014-12-012014-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article8application/pdfhttp://hdl.handle.net/10362/149802eng1198-743XPURE: 54406387https://doi.org/10.1111/1469-0691.12738info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T18:09:33Zoai:run.unl.pt:10362/149802Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:39:57.172563Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit The INFAUCI study |
| title |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit |
| spellingShingle |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit Gonçalves-Pereira, J. Antibiotics Epidemiology Infection Intensive Care Unit Outcome Process of care Microbiology (medical) Infectious Diseases SDG 3 - Good Health and Well-being |
| title_short |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit |
| title_full |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit |
| title_fullStr |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit |
| title_full_unstemmed |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit |
| title_sort |
Impact of infection on admission and of the process of care on mortality of patients admitted to the Intensive Care Unit |
| author |
Gonçalves-Pereira, J. |
| author_facet |
Gonçalves-Pereira, J. Pereira, J. M. Ribeiro, O. Baptista, J. P. Froes, F. Paiva, J. A. |
| author_role |
author |
| author2 |
Pereira, J. M. Ribeiro, O. Baptista, J. P. Froes, F. Paiva, J. A. |
| author2_role |
author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) RUN |
| dc.contributor.author.fl_str_mv |
Gonçalves-Pereira, J. Pereira, J. M. Ribeiro, O. Baptista, J. P. Froes, F. Paiva, J. A. |
| dc.subject.por.fl_str_mv |
Antibiotics Epidemiology Infection Intensive Care Unit Outcome Process of care Microbiology (medical) Infectious Diseases SDG 3 - Good Health and Well-being |
| topic |
Antibiotics Epidemiology Infection Intensive Care Unit Outcome Process of care Microbiology (medical) Infectious Diseases SDG 3 - Good Health and Well-being |
| description |
Funding Information: Financial support: this work was supported by an unrestricted grant from GIS (Grupo de Infecção e Sepsis, Hospital de São João, Porto, Portugal). Publisher Copyright: © 2014 European Society of Clinical Microbiology and Infectious Diseases2012 December 2014 10.1111/1469-0691.12738 Original Article INFECTIOUS DISEASES Original Articles © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases. |
| publishDate |
2014 |
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2014-12-01 2014-12-01T00:00:00Z 2023-02-27T22:23:53Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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http://hdl.handle.net/10362/149802 |
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http://hdl.handle.net/10362/149802 |
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eng |
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eng |
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1198-743X PURE: 54406387 https://doi.org/10.1111/1469-0691.12738 |
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8 application/pdf |
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