Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort
Authors' conclusion
Device-associated HAI significantly contribute to hospital mortality and impose a high excess risk of death for critically ill patients.
Study context
- Population
- Critically ill ICU patients in Brazil, September 2019 to December 20234,066 (3.2%) with healthcare infections (HAI)
- Participants
- 128,247 patients
- Exposure
- Device-associated HAI vs no HAI
- HAIn = 4,066
- Ventilator associated pneumonia (VAP)n = 2,742
- Central line associated bloodstream infection (CLABSI)n = 1,493
- Catheter associated urinary tract infection (CAUTI)n = 433
- ≥ 2 HAIn = 435
- Outcome
- Population attributable in-hospital mortality fraction (PAF) and absolute in-hospital mortality difference (AMD) of HAI
Methodological detailsprospective individual patient data collection, adjusted disability multistate model
- Prospective individual patient data collection
- Adjusted disability multistate model
Main finding
As reported in the abstract
In-hospital mortality attributable to HAI
| Group | PAF | AMD |
|---|---|---|
| HAI | 3.89% (95% CI 3.68-4.11%) | 33.69% (95% CI 32.27-35.33%) |
| VAP | 2.16% (2.05-2.33%) | 29.01% (27.15-30.98%) |
| CLABSI | 1.2% (1.08-1.32%) | 31.64% (29.3-34.81%) |
| CAUTI | 0.11% (0.07-0.16%) | 9.94% (3.88-15.54%) |
| ≥ 2 HAI | 0.33% (0.26-0.4%) | 35.6% (28.93-42.99%) |
PAF
HAI3.89% (95% CI 3.68-4.11%)
VAP2.16% (2.05-2.33%)
CLABSI1.2% (1.08-1.32%)
CAUTI0.11% (0.07-0.16%)
≥ 2 HAI0.33% (0.26-0.4%)
AMD
HAI33.69% (95% CI 32.27-35.33%)
VAP29.01% (27.15-30.98%)
CLABSI31.64% (29.3-34.81%)
CAUTI9.94% (3.88-15.54%)
≥ 2 HAI35.6% (28.93-42.99%)
Observational data: associations, not effects.
Original publication
Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort. Crit Care. Published 3 January 2025. doi:10.
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