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Open Access Highly Accessed Research

Intensive care acquired infection is an independent risk factor for hospital mortality: a prospective cohort study

Pekka Ylipalosaari1*, Tero I Ala-Kokko2, Jouko Laurila2, Pasi Ohtonen3 and Hannu Syrjälä1

Author Affiliations

1 Department of Infection Control, Oulu University Hospital, FIN-90029 OYS, Finland

2 Department of Anesthesiology, Division of Intensive Care, Oulu University Hospital, FIN-90029 OYS, Finland

3 Departments of Anesthesiology and Surgery, Oulu University Hospital, FIN-90029 OYS, Finland

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Critical Care 2006, 10:R66  doi:10.1186/cc4902

Published: 20 April 2006

Abstract

Introduction

The aim of this study was to elucidate the impact of intensive care unit (ICU)-acquired infection on hospital mortality.

Methods

Patients with a longer than 48 hour stay in a mixed 10 bed ICU in a tertiary-level teaching hospital were prospectively enrolled between May 2002 and June 2003. Risk factors for hospital mortality were analyzed with a logistic regression model.

Results

Of 335 patients, 80 developed ICU-acquired infection. Among the patients with ICU-acquired infections, hospital mortality was always higher, regardless of whether or not the patients had had infection on admission (infection on admission group (IAG), 35.6% versus 17%, p = 0.008; and no-IAG, 25.7% versus 6.1%, p = 0.023). In IAG (n = 251), hospital stay was also longer in the presence of ICU-acquired infection (median 31 versus 16 days, p < 0.001), whereas in no-IAG (n = 84), hospital stay was almost identical with and without the presence of ICU-acquired infection (18 versus 17 days). In univariate analysis, the significant risk factors for hospital mortality were: Acute Physiology and Chronic Health Evaluation (APACHE) II score >20, sequential organ failure assessment (SOFA) score >8, ICU-acquired infection, age ≥ 65, community-acquired pneumonia, malignancy or immunosuppressive medication, and ICU length of stay >5 days. In multivariate logistic regression analysis, ICU-acquired infection remained an independent risk factor for hospital mortality after adjustment for APACHE II score and age (odds ratio (OR) 4.0 (95% confidence interval (CI): 2.0–7.9)) and SOFA score and age (OR 2.7 (95% CI: 2.9–7.6)).

Conclusion

ICU-acquired infection was an independent risk factor for hospital mortality even after adjustment for the APACHE II or SOFA scores and age.