| الوصف: |
Background Effective prevention of healthcare-associated infections (HAIs) requires early identification of at-risk patients. There is no score designed to predict HAIs. The present study was aimed to explore an available score, Systemic inflammatory syndrome (SIRS) score, on admission in predicting HAIs among critically ill patients. Methods This study was based on the Medical Information Mart for Intensive Care III (MIMIC III) version 1.4. Patients with HAIs were matched with control patients who had no HAIs in a 1:1 ratio based on age, gender, mechanical ventilation, deep venous catheterization, urethral catheterization, and surgical operation. Subgroup analyses were conducted according to various variables including infection likelihood on admission. The prognostic values of SIRS and infectious SIRS on admission in predicting HAIs were analyzed using logistic regression. Results A total of 2437 patients with HAIs and 2437 matched controls were enrolled in the final analysis. Adjusted odds ratio (ORs) (95% confidence interval [CI]) for HAIs of SIRS scores (1 to 4) on admission was 1.48 (0.77-2.83), 1.86 (0.99-3.47), 2.14 (1.15-3.98), and 2.58 (1.39-4.80). Adjusted ORs (95%CI) for HAIs of SIRS (score≥2) and infectious SIRS were 1.57 (1.27-1.94) and 1.78 (1.52-2.09), respectively. Subgroup analyses showed that SIRS on admission was an independent risk factor for HAIs in patients admitted without definite and probable infection likelihood (OR=1.54, 95%CI 1.28-1.93). However, it was not a risk factor for HAIs inpatients admitted with infection, in non-white patients, and in patients with liver disease or obesity, and in patients who received total parenteral nutrition (TPN) (all P>0.05). In addition, it was showed that infectious SIRS on admission was not a risk factor for HAIs in black patients and in patients with obesity, and those received TPN (all P>0.05). Conclusions Infectious SIRS on admission significantly predicts HAIs among critical illness patients. SIRS on admission was a predictor of HAIs in ICU patients admitted without infection but not in patients admitted with infection. |
