Impact of healthcare-associated sepsis on mortality in critically ill infants.
Unlabelled: Healthcare-associated sepsis (HAS) is a life-threatening complication in neonatal intensive care. Research into the impact of HAS on mortality adjusted for comorbidities is however limited. We conducted a historical cohort study to evaluate impact of HAS on mortality stratified by birth...
| Publicado en: | European Journal of Pediatrics Vol. 175; no. 7; pp. 943 - 953 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jul2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116146412&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116146412 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Jul2016 vid: 175 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 116146412 116146412 NLM27118596 116146412 10.1007/s00431-016-2726-6 NLM27118596 116146412 ppf: 943 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Impact of healthcare-associated sepsis on mortality in critically ill infants. aug: au: Verstraete, Evelien Mahieu, Ludo De Coen, Kris Vogelaers, Dirk Blot, Stijn Verstraete, Evelien Hilde affil: Department of Internal Medicine, Ghent University, Ghent Belgium sug: subj: Cross Infection Epidemiology Intensive Care Units, Neonatal Statistics and Numerical Data Cross Infection Microbiology Male Risk Factors Infant Infant, Newborn Female Logistic Regression Hospital Mortality Incidence Comorbidity Infant, Very Low Birth Weight Prospective Studies Human Infant: 1-23 months Infant, Newborn: birth-1 month Male Female ab: Unlabelled: Healthcare-associated sepsis (HAS) is a life-threatening complication in neonatal intensive care. Research into the impact of HAS on mortality adjusted for comorbidities is however limited. We conducted a historical cohort study to evaluate impact of HAS on mortality stratified by birth weight and risk factors for mortality in the HAS cohort. HAS was defined according to the National Institute of Child Health and Human Development criteria. Logistic regression was used to calculate adjusted odds of mortality. Of 5134 admissions, 342 infants developed HAS (6.7 %). Mortality in the total and HAS cohort was 5.6 and 10.5 %, respectively. The majority of HAS was caused by commensals (HAS-COM, 59.4 %) and 40.6 % by recognized pathogens (HAS-REC). Adjusted for comorbidities, "HAS-REC" is only a risk factor for mortality in newborns >1500 g (adjusted odds ratio [aOR] 2.3, confidence interval [CI] 1.1-4.9). Post-hoc analysis identified HAS-REC as an independent risk factor for mortality in infants with gastrointestinal disease (aOR 4.8, CI 2.1-10.8). "Renal insufficiency," "focal intestinal perforation," and "necrotizing enterocolitis" are independent risk factors for mortality in the HAS cohort (aOR 13.5, CI 4.9-36.6; aOR 7.7, CI 1.5-39.2; aOR 2.1, CI 1.0-4.7, respectively).Conclusion: For very low birth weight infants (≤1500 g), several comorbidities overrule the impact of HAS on mortality. After adjustment for comorbidities, HAS-REC independently predicts in-hospital mortality in heavier infants and in those with gastrointestinal disease.What Is Known: • The relationship between healthcare-associated sepsis and mortality is influenced by the causative pathogen and is confounded by comorbidities. • Research on impact of healthcare-associated sepsis on mortality adjusted for comorbidities is limited as well as research on independent risk factors for mortality in neonates with sepsis. What is New: • We included a large list of comorbidities and stratified risk by birth weight in order to assess the true effect of healthcare-associated sepsis on mortality. • Risk for mortality was calculated for commensal flora and for recognized pathogens as causative micro-organisms. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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