Hospital-Acquired Infection Underlies Poor Functional Outcome in Patients with Prolonged Length of Stay

Alexander J. George; Amelia K. Boehme; James E. Siegler; Dominique Monlezun; Bethena D. Fowler; Amir Shaban; Karen C. Albright; T. Mark Beasley; Sheryl Martin-Schild

doi:10.1155/2013/312348

Back

Hospital-Acquired Infection Underlies Poor Functional Outcome in Patients with Prolonged Length of Stay

Journal article

Open access

Peer reviewed

Hospital-Acquired Infection Underlies Poor Functional Outcome in Patients with Prolonged Length of Stay

Alexander J. George, Amelia K. Boehme, James E. Siegler, Dominique Monlezun, Bethena D. Fowler, Amir Shaban, Karen C. Albright, T. Mark Beasley and Sheryl Martin-Schild

ISRN stroke, Vol.2013, pp.1-5

09/15/2013

DOI: 10.1155/2013/312348

PMCID: PMC3873143

PMID: 24377056

Files and links (1)

url

https://doi.org/10.1155/2013/312348View

Published (Version of record) Open Access

Abstract

Introduction . Prolonged length of stay (pLOS) following ischemic stroke inflates cost, increases risk for hospital-acquired complications, and has been associated with worse prognosis. Methods . Acute ischemic stroke patients admitted between July 2008 and December 2010 were retrospectively analyzed for pLOS, defined as a patient stable for discharge hospitalized for an additional ≥24 hours. Results . Of 274 patients included, 106 (38.7%) had pLOS (median age 65 years, 60.6% female, 69.0% black). Patients with pLOS had higher admission NIHSS than patients without pLOS (9 versus 5, P = 0 . 0010 ). A larger proportion of patients with pLOS developed an infection ( P < 0.0001 ), and after adjusting for covariates, these patients had greater odds of poor short-term functional outcome (OR = 2.25, 95% CI 1.17–4.32, P = 0 . 0148 ). Adjusting for infection, the odds of patients with pLOS having poor short-term functional outcome were no longer significant (OR = 1.68, 95% CI 0.83–3.35, P = 0 . 1443 ). Conclusions. The contraction of a hospital-acquired infection was a significant predictor of pLOS and a contributor of poor short-term outcome following an ischemic stroke. Whether the cause or the consequence of pLOS, hospital-acquired infections are largely preventable and a target for reducing length of stay.

Details

Title: Subtitle: Hospital-Acquired Infection Underlies Poor Functional Outcome in Patients with Prolonged Length of Stay
Creators: Alexander J. George - Stroke Program at Tulane University Hospital, Department of Neurology, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
Amelia K. Boehme - Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35294-0022, USA, Department of Neurology, School of Medicine, University of Alabama at Birmingham, 1670 University Blvd., Birmingham, AL 35233-0022, USA
James E. Siegler - Stroke Program at Tulane University Hospital, Department of Neurology, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
Dominique Monlezun - Stroke Program at Tulane University Hospital, Department of Neurology, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
Bethena D. Fowler - Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35294-0022, USA, Department of Neurology, School of Medicine, University of Alabama at Birmingham, 1670 University Blvd., Birmingham, AL 35233-0022, USA
Amir Shaban - Tulane University
Karen C. Albright - Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35294-0022, USA, Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), 1530 3rd Avenue South, Medical Towers, Birmingham, AL 35294-4410, USA, Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), Medical Towers Building, 1717 11th Avenue South, Suite 516A, Birmingham, AL 35294-4410, USA
T. Mark Beasley - University of Alabama at Birmingham
Sheryl Martin-Schild - Stroke Program at Tulane University Hospital, Department of Neurology, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
Resource Type: Journal article
Publication Details: ISRN stroke, Vol.2013, pp.1-5
DOI: 10.1155/2013/312348
PMID: 24377056
PMCID: PMC3873143
NLM abbreviation: ISRN Stroke
ISSN: 2090-9454
eISSN: 2090-9454
Grant note: DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: 5 T32 HS013852-10, 3 P60 MD000502-08S1, 13PRE13830003
Language: English
Date published: 09/15/2013
Academic Unit: Neurology
Record Identifier: 9984303444002771

Metrics

8 Record Views