Investıgatıon of Rısk Factors Assocıated with Nosocomıal Infectıon Development and Mortalıty in Intensıve Care Unıts

Abstract

Objective: Mortality rates are high in patients who develop nosocomial infections (NI) in intensive care units (ICUs). In our study, we aimed to determine the risk factors for NI and NI-associated mortality in ICU patients. Material and Method: Patients hospitalized in ICU in Dışkapı Yıldırım Beyazıt Training and Research Hospital between 2017-2018 were evaluated retrospectively. Patients aged 18 years and older, staying in ICU for at least 48 hours and not diagnosed with infection at the time of hospitalization were included in the study. Results: A total of 200 patients were included in the study. During hospitalization period in ICU; 103 (51.5%) patients developed NI and 97 (48.5%) patients did not develop NI. The mean age of patients was 71.6±15.5, 107 (53.5%) were female and the median hospitalization lenght was 8 (3-144) days. When gender, age, Acute Physiology and Chronic Health Evaluation II score (APACHE-II), Charlson Comorbidity Index, Glasgow Coma Score, presence of invasive mechanical ventilation (IMV), examined with multivariate analysis, it was determined that the length of stay in the intensive care unit increased the development of hospital infection by 1.14 times and the presence of central venous catheter by 3.5 times. When the risk factors for mortality in patients who developed NI were examined by multivariate analysis, it was determined that a 1-unit increase in APACHE-II score increased mortality 1.13 times, while IMV increased it 4,43 times. Conclusion: Patients hospitalized in the ICU have many risk factors for the development of NI. It is extremely important to determine the risk factors for NI and mortality in these patients, and compliance with infection control measures is extremely important.