Journal article
Incidence and clinical outcomes of nosocomial infections in patients presenting with STEMI complicated by cardiogenic shock in the United States
Heart & lung, Vol.49(6), pp.716-723
11/01/2020
DOI: 10.1016/j.hrtlng.2020.08.008
PMID: 32866743
Abstract
Objectives: This study addresses the incidence, trends, and impact of nosocomial infections (NI) on the out-comes of patients admitted with ST-segment elevation myocardial infarction (STEMI) and cardiogenic shock (STEMI-CS) using the United States National Inpatient Sample (NIS) database. Methods: We analyzed data from 105,184 STEMI-CS patients using the NIS database from the years 20052014. NI was defined as infections of more than or equal to three days, comprising of central line-associated bloodstream infection (CLABSI), urinary tract infection (UTI), hospital-acquired pneumonia (HAP), Clostridium difficile infection (CDI), bacteremia, and skin related infections. Outcomes of the impact of NI on STEMI-CS included in-hospital mortality, length of hospital stay (LOS) and costs. Significant associations of NI in patients admitted with STEMI-CS were also identified. Results: Overall, 19.1% (20,137) of patients admitted with STEMI-CS developed NI. Trends of NI have decreased from 2005-2014. The most common NI were UTI (9.2%), followed by HAP (6.8%), CLABSI (1.5%), bacteremia (1.5%), skin related infections (1.5%), and CDI (1.3%). The strongest association of developing a NI was increasing LOS (7-9 days; OR: 1.99; 95% CI: 1.75-2.26; >9 days; OR: 4.51; 95% CI: 4.04-5.04 compared to 4-6 days as reference). Increased mortality risk among patients with NI was significant, especially those with sepsis-associated NI compared to those without sepsis (OR: 2.95; 95% CI: 2.72-3.20). Patients with NI were found to be associated with significantly longer LOS and higher costs, irrespective of percutaneous mechanical circulatory support placement. Conclusions: NI were common among patients with STEMI-CS. Those who developed NI were at a greater risk of in-hospital mortality, increased LOS and costs. Published by Elsevier Inc.
Details
- Title: Subtitle
- Incidence and clinical outcomes of nosocomial infections in patients presenting with STEMI complicated by cardiogenic shock in the United States
- Creators
- Omar Chehab - Wayne State UniversityRami Z. Morsi - University of ChicagoAmjad Kanj - Mayo ClinicRayan Jo Rachwan - University of Wisconsin–MadisonMohit Pahuja - Wayne State UniversityShareef Mansour - University of IowaHussam Tabaja - Wayne State UniversityUsman Ahmad - Wayne State UniversitySaid El Zein - Wayne State UniversityMohammad Raad - Henry Ford HospitalAli Saker - Wayne State UniversityPaulino Alvarez - University of IowaAlexandros Briasoulis - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Heart & lung, Vol.49(6), pp.716-723
- Publisher
- Elsevier
- DOI
- 10.1016/j.hrtlng.2020.08.008
- PMID
- 32866743
- ISSN
- 0147-9563
- eISSN
- 1527-3288
- Number of pages
- 8
- Language
- English
- Date published
- 11/01/2020
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984359851602771
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