Hospital-acquired infections dramatically increase trauma patients' risk of in-hospital death and hospital stay
Research Activities, August 2011, No. 372
Hospital-acquired infections (HAIs) are among the top five leading causes of death in the United States, striking 4.5 of every 100 patients admitted to the hospital. A new study finds that trauma patients who develop HAIs during treatment have up to six times the in-hospital mortality rate than similar patients without HAIs. It found that women were 30 percent less likely to have HAIs than men (adjusted OR [AOR] = 0.70; 1 is equal odds). Compared with patients hospitalized for blunt trauma, patients whose trauma was caused by a motor vehicle accident had 25 percent greater odds of developing an HAI, while those suffering from pedestrian trauma had 48 percent great odds; gunshot wound, 28 percent greater odds; and stab wound, 74 percent greater odds.
Among the HAIs, patients with sepsis had nearly six times higher risk of hospital death than uninfected trauma patients. Patients with other HAIs had 1.5 to nearly twice the risk of hospital death than trauma patients without HAIs. In addition, trauma patients with HAIs had approximately 2- to 2.5-fold higher health care costs and approximately 2-fold longer hospital stays than uninfected trauma patients.
Laurent G. Glance, M.D., of the University of Rochester School of Medicine, and colleagues analyzed data on 155,891 trauma patients from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample. They defined HAI groups using the diagnostic codes for sepsis, pneumonia, Staphylococcus infections, and Clostridium difficile-associated disease. The study was funded by the Agency for Healthcare Research and Quality (HS16737).
More details are in "Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients," by Dr. Glance, Pat W. Stone, Ph.D., Dana B. Mukamel, Ph.D, and others in the March 21, 2011, online Archives of Surgery.