Impact of Comorbidities on Hospital-Acquired Infections in a Geriatric Rehabilitation Unit: Prospective Study of 252 Patients

摘要: Abstract Objectives Hospital-acquired infections (HAIs) remain a major source of morbidity and mortality in long-term care units, despite advances antimicrobial therapy preventive measures. Our aim was to investigate risk factors for HAIs, especially the elderly, describe relationship between comorbidities (number, severity, specific diseases) HAIs using comprehensive inventory comorbidities. Design Prospective cohort study Setting Geriatric rehabilitation unit university hospital Paris metropolitan area. Participants were 252 consecutive patients aged 75 years or older (mean age, 85 ± 6.2 years) admitted 2006 and 2008. Measurements Surveillance HAI conducted. A complete done Cumulative Illness Rating Scale Geriatrics (CIRS-G). Potential evaluated 2 models, one with acquisition, CIRS-G, activities daily living score less than 10, at least 1 invasive procedure (yes/no) other acquisition procedures diseases. Results Of patients, 97 experienced an incidence 5.6 per 1000 bed-days. The most common sites respiratory tract (48%; 65/136) urinary (37%; 51/136). CIRS-G global comorbidity index higher without HAIs. Among categories, urogenital diseases more prevalent group In model combining procedure, independent (odds ratio [OR], 1.55; 95% confidence interval [95% CI], 1.13–2.11; P  = .005) (OR, 5.18; CI, 2.77–9.71; .006), gastrointestinal endoscopy 3.69; 1.12–12.16; .03), pressure sores 2.52; 1.04–6.10; swallowing impairment 3.37; 1.16–9.74; .02). Conclusions This identified several important There is need prevention via implementation infection-control programs, including surveillance, units.