Mediha Turktan1, Oznur Ak2, Hakan Erdem3, Dilek Ozcengiz1, Sally Hargreaves4, Safak Kaya5, Emre Karakoc6, Ozlem Ozkan-Kuscu6, Gunay Tuncer-Ertem7, Recep Tekin8, Handan Birbicer9, Gul Durmus10, Canan Yilmaz11, Funda Kocak12, Edmond Puca13, Jordi Rello14. 1. Cukurova University School of Medicine, Department of Anesthesiology and Reanimation Adana, Turkey. 2. Dr. Lutfi Kirdar Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey. 3. Gulhane Medical Academy, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey. Electronic address: hakanerdem1969@yahoo.com. 4. International Health Unit, Section of Infectious Diseases and Immunity, Commonwealth Building, Hammersmith Campus, Imperial College London, London, United Kingdom. 5. Gazi Yasargil Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey. 6. Cukurova University School of Medicine, Department of Internal Medicine, Adana, Turkey. 7. Ankara Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey. 8. Dicle University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey. 9. Mersin University School of Medicine, Department of Anesthesiology and Reanimation, Mersin, Turkey. 10. Bursa Yüksek Ihtisas Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey. 11. Bursa Yüksek Ihtisas Training and Research Hospital, Department of Anesthesiology and Reanimation, Bursa, Turkey. 12. Basaksehir State Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey. 13. University Hospital Center "Mother Teresa", Department of Infectious Diseeases, Tirana, Albania. 14. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autonoma de Barcelona, Spain.
Abstract
OBJECTIVES: Data on the impact of refugees on Intensive Care Units (ICUs) are lacking in the literature, in particular for community-acquired (CA) infectious diseases, for which they are known to be at higher risk. We did a descriptive, multicenter study to analyze CA infections among refugee patients requiring ICU admission. METHODS: Inclusion criteria were adult refugee patients admitted to an ICU due to CA infections. Anonymized data were collected between January 1, 2010 and December 30, 2015 across 10 referral centers. RESULTS: 29.885 patients were admitted to the ICUs in the study period. 37 patients were included the study, the majority were from Syria (n=31, 83.8%). Mean (SD) age of the patients was 45.92±20.16years. The 5-year prevalence rate was 123.8 per 100.000 patients in the ICUs. All patients had at least one comorbid condition. Forty-nine CA infections were diagnosed. The most common CA infection was pneumonia (49%) followed by urinary-tract infections (16.3%). 21 patients (56.7%) hospitalized in the ICU had trauma history. Mortality rate was high at 22 patients (59.5%) with 5 (22.7%) deaths directly attributed to CA infections. CONCLUSIONS: Refugees presented to ICUs with CA infections similar to the host populations (pneumonia and urinary-tract infections) but had high mortality rates (59.5%). It seems that Turkish ICUs were not congested with the refugee patients' influx for CA infections. More research needs to be done to better understand how to deliver preventative and timely health care services to this group of patients.
OBJECTIVES: Data on the impact of refugees on Intensive Care Units (ICUs) are lacking in the literature, in particular for community-acquired (CA) infectious diseases, for which they are known to be at higher risk. We did a descriptive, multicenter study to analyze CA infections among refugee patients requiring ICU admission. METHODS: Inclusion criteria were adult refugee patients admitted to an ICU due to CA infections. Anonymized data were collected between January 1, 2010 and December 30, 2015 across 10 referral centers. RESULTS: 29.885 patients were admitted to the ICUs in the study period. 37 patients were included the study, the majority were from Syria (n=31, 83.8%). Mean (SD) age of the patients was 45.92±20.16years. The 5-year prevalence rate was 123.8 per 100.000 patients in the ICUs. All patients had at least one comorbid condition. Forty-nine CA infections were diagnosed. The most common CA infection was pneumonia (49%) followed by urinary-tract infections (16.3%). 21 patients (56.7%) hospitalized in the ICU had trauma history. Mortality rate was high at 22 patients (59.5%) with 5 (22.7%) deaths directly attributed to CA infections. CONCLUSIONS: Refugees presented to ICUs with CA infections similar to the host populations (pneumonia and urinary-tract infections) but had high mortality rates (59.5%). It seems that Turkish ICUs were not congested with the refugee patients' influx for CA infections. More research needs to be done to better understand how to deliver preventative and timely health care services to this group of patients.
Authors: Tobias Schilling; Stephan Rauscher; Christian Menzel; Simon Reichenauer; Martina Müller-Schilling; Stephan Schmid; Michael Selgrad Journal: Visc Med Date: 2017-07-19