Author:
Bartolo Michelangelo,Zucchella Chiara,Aabid Hend,Valoriani Beatrice,Copetti Massimiliano,Fontana Andrea,Intiso Domenico,Mancuso Mauro
Abstract
AbstractTo describe healthcare-associated infections in inpatient neuro-rehabilitation and their impact on functional outcome, a multicenter observational study with severe acquired brain injury (sABI) patients was performed. Patients were divided into infected (INF-group) or not infected (noINF-group) and assessed at admission and discharge, by means of the Glasgow Coma Scale (GCS), the Rancho Los Amigos Levels of Cognitive Functioning Scale (LCF), the Disability Rating Scale (DRS), and the modified Barthel Index (mBI). One hundred-nineteen patients were included in the INF-group, and 109 in the noINF-group. Culture specimens were found positive for bloodstream (43.8%), respiratory tract (25.7%), urinary tract (16.2%), gastro-intestinal system (8.6%) and skin (2.4%) infections. Multiple microorganisms were the most frequent (58.1%) and 55.5% of patients needed functional isolation due to multidrug resistant germs. The functional status of both groups improved after rehabilitation, but multivariable analyses showed that the INF-group showed a significantly lower gain to GCS (p = 0.008), DRS (p = 0.020) and mBI (p = 0.021) compared to the noINF-group. Length of stay (LOS) and number of skipped rehabilitative sessions were not statistically different between the groups; mortality rate was significantly higher in the INF-group (p = 0.04). Infected sABI patients showed longer LOS, significant increased mortality, and a lower functional outcome than not infected patients.
Publisher
Springer Science and Business Media LLC
Reference39 articles.
1. Garner, J. S., Jarvis, W. R., Emori, T. G., Horan, T. C. & Hughes, J. M. CDC definitions for nosocomial infections. Am. J. Infect. Control 16, 128–140. https://doi.org/10.1016/0196-6553(88)90053-3 (1988).
2. European Centre for Disease Prevention and Control (ECDC). Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in European Acute Care Hospitals (European Centre for Disease Prevention and Control, 2013).
3. Mylotte, J. M., Graham, R., Kahler, L., Young, B. L. & Goodnough, S. Impact of nosocomial infection on length of stay and functional improvement among patients admitted to an acute rehabilitation unit. Infect. Control Hosp. Epidemiol. 22, 83–87. https://doi.org/10.1086/501868 (2001).
4. Popović, N. et al. The frequency of poststroke infections and their impact on early stroke outcome. J. Stroke Cerebrovasc. 22, 424–429. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.03.003 (2013).
5. Suda, S. et al. Stroke-associated infection independently predicts 3-month poor functional outcome and mortality. J. Neurol. 265, 370–375. https://doi.org/10.1007/s00415-017-8714-6 (2018).
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献