دورية أكاديمية
Prevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study.
| العنوان: | Prevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study. |
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| عنوان ترانسليتريتد: | Prevalência e desfechos clínicos de infecções em UTIs brasileiras: subanálise do estudo EPIC II. |
| المؤلفون: | Silva E, Dalfior Junior L, Fernandes Hda S, Moreno R, Vincent JL |
| المصدر: | Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2012 Jun; Vol. 24 (2), pp. 143-50. |
| نوع المنشور: | Journal Article |
| اللغة: | English; Portuguese |
| بيانات الدورية: | Publisher: Associação de Medicina Intensiva Brasileira Country of Publication: Brazil NLM ID: 9506692 Publication Model: Print Cited Medium: Internet ISSN: 1982-4335 (Electronic) Linking ISSN: 0103507X NLM ISO Abbreviation: Rev Bras Ter Intensiva Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Rio de Janeiro] : Associação de Medicina Intensiva Brasileira, |
| مستخلص: | Objective: To determine the prevalence of infections in Brazilian intensive care units and the associated mortality by analyzing the data obtained in the Extended Prevalence of Infection in Intensive Care (EPIC II) study. Methods: EPIC II was a multicenter, international, cross-sectional prospective study of infection prevalence. It described the demographic, physiological, bacteriological, and therapeutic characteristics, outcome up to the 60th day, prevalence of infection, and mortality of all the patients admitted to the participating ICUs between zero hour and midnight on May 8, 2007. A total of 14,414 patients were included in the original study. Of these 14,414 patients, 1,235 were Brazilian and were hospitalized in 90 Brazilian ICUs. They represent the focus of this study. Results: Among these 1,235 Brazilian patients, 61,6% had an infection on the day of the trial, and the lungs were the main site of infection (71.2%). Half of the patients had positive cultures, predominantly gram-negative bacilli (72%). On the day of the study, the median SOFA score was 5 (3-8) and the median SAPS II score was 36 (26-47). The infected patients had SOFA scores significantly higher than those of the non-infected patients 6 (4-9) and 3 (2-6), respectively). The overall ICU mortality rate was 28.4%: 37.6% in the infected patients, and 13.2% in the non-infected patients (p<0.001). Similarly, the in-hospital mortality rate was 34.2%, with a higher rate in the infected than in the non-infected patients (44.2% vs. 17.7%) (p<0.001). In the multivariate analysis, the main factors associated with infection incidence were emergency surgery (OR 2.89, 95%CI [1.72-4.86], p<0.001), mechanical ventilation (OR 2.06, 95% CI [1.5-2.82], p<0.001), and the SAPS II score (OR 1.04, 95% CI [1.03-1.06], p<0.001). The main factors related to mortality were ICC functional class III/ IV (OR 3.0, 95% CI [1.51-5.98], p<0.01), diabetes mellitus (OR 0.48, 95% CI [0.25-0.95], p<0.03), cirrhosis (OR 4.62, 95% CI [1.47-14,5], p<0.01), male gender (OR 0.68, 95% CI [0.46-1.0], p<0.05), mechanical ventilation (OR 1.87, 95% CI [1.19-2.95], p<0.01), hemodialysis (OR 1.98, 95% CI [1.05-3.75], p<0.03), and the SAPS II score (OR 1.08, 95% CI [1.06-1.10], p<0.001). Conclusion: The present study revealed a higher prevalence of infections in Brazilian ICUs than has been previously reported. There was a clear association between infection and mortality. |
| تواريخ الأحداث: | Date Created: 20130807 Date Completed: 20151026 Latest Revision: 20130806 |
| رمز التحديث: | 20231215 |
| PMID: | 23917761 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1982-4335 |
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