Degree of Dependence and Risk of Nosocomial Infection
DOI:
https://doi.org/10.24950/rspmi/O/231/18/3/2019Keywords:
Aged, Cross Infection, Personal Autonomy, Risk FactorsAbstract
Introduction: Incidence of nosocomial infections gradually
increase over the age of 65. The primary objective of this
paper was to assess the impact of the reduction or loss of
autonomy of the elderly patients in the nosocomial infection
acquisition.
Material and Methods: Prospective analysis of hospitalized
patients from March 2017 to February 2018 at the Department of Internal Medicine of Vila Real Hospital, with an evaluation of the dependence level through the Katz scale and
nosocomial infection acquisition. Other variables were analyzed: compromised systems and risk factors in nosocomial
infections, mean duration of hospitalization, mortality and readmission.
Results: A total of 1311 patients were analyzed, with a mean
age of 83.2. Of the patients’ sample, 33.6% were autonomous, 32.6% were partially dependent and 33.7% were totally dependent. Nosocomial infection was observed in 10.6%
of patients. There was a statistically significant association
between the dependence level and the nosocomial infections acquisition, as well as between the presence of nosocomial infection and mortality, and readmission after 30 days.
The dependence level was also significantly associated with
days of hospitalization, with mortality and with readmission.
Discussion and Conclusion: This study revealed that nosocomial infection development was superior in patients with
a greater dependence level as well as the mortality, which
was also higher in this subgroup of patients. In this way, the
loss of autonomy should be considered as a predisposing
potential for acquisition of infection.
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References
Solis-Hernandez PS, Vidales-Reyes M, Garza-Gonzalez E, Guajardo-Alvarez G, Chavez-Moreno S, Camacho-Ortiz A. Hospital-acquired infections in elderly versus younger patients in an acute care hospital. Int J Infect. 2016; 3:e32620.
Ribas RM, Gontijo PP. Comparing hospital infections in the elderly versus younger adults: an experience in a Brazilian university hospital. Brazil J Infect Dis. 2003;7:210-5.
Oberoi L, Neki NS, Kaur R, Oberoi R. Changing trends of nosocomial infections in geriatric patients in a tertiary care hospital. J Int Med Sci Acad. 2012; 25:233-4.
Ozdemir K., Dizbay M. Nosocomial infection and risk factors in elderly patients in intensive care units. J Microbiol Infect Dis. 2015;5:38-43.
Inci A, Karabay A, Erus S, Demiraran Y. Nosocomial infections and associated risk factors in geriatric patients in the intensive care unit. Eurasian J Emerg Med. 2016;15:177-80.
Núcleo de estudos de Geriatria da Sociedade Portuguesa de Medicina Interna (GERMI). Avaliação Geriátrica [Acedido em 10 Setembro 2018] Disponível em:https://www.spmi.pt/docs_nucleos/GERMI_36.pdf
Programa Nacional de Controlo de Infecção. Critérios do CDC para o Diagnóstico das Infecções. Lisboa: PNCI; 2003.
CDC/NHSN Surveillance Definitions for Specific Types of Infections. [Acedido em 10 Setembro 2018] Disponível em:https://www.cdc.gov/ nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf
Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events. [Acedido em 10 Setembro 2018] Disponível em:https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf
Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia [PNEU]) Event. [Acedido em 10 Setembro 2018] Disponível em:https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf
Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and Non-central Line Associated Bloodstream Infection).[Acedido em 10 Setembro 2018] Disponível em:https://www.cdc.gov/nhsn/pdfs/ pscmanual/4psc_clabscurrent.pdf
Haddadi A, Lemdani M, Hubert H. Incidence, dependent and independent risk factors associated to nosocomial infections and to the mortality at the intensive care unit of the Timone University Hospital. Eur Scientif J. 2013;9: 168-81.
Pittet D, Harbarth S, Ruef C, Francioli P, Sudre P, Pétignat C, et al. Prevalence and Risk Factors for Nosocomial Infections in Four University Hospitals in Switzerland. Infect Control Hosp Epidemiol. 1999;20:37-42.
Ozer B, Tatman-Otkun M, Memis D, Otkun M. Nosocomial infections and risk factors in intensive care unit of a university hospital in Turkey. Central Eur J Med. 2010; 5:203-8.
Wiedenkeller B, Modert F, Karleskind I. The dependence level of the elderly person influences the risk of infection. Bull Soc Sci Med Grand Duche Luxemb. 2012;:32-42.
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