BACKGROUND: The International Nosocomial Infection Control Consortium (INICC) has found a high ICU mortality rate in Latin America. METHODS: A prospective cohort study in 198 ICUs of 96 hospitals in 46 cities in 12 Latin American countries to identify mortality risk factors (RF), and data were analyzed using multiple logistic regression. RESULTS: Between 07/01/1998 and 02/12/2022, 71,685 patients, followed during 652,167 patient-days, acquired 4700 HAIs, and 10,890 died. We prospectively collected data of 16 variables. Following 11 independent mortality RFs were identified in multiple logistic regression: ventilator-associated pneumonia (VAP) acquisition (adjusted odds ratio [aOR] = 1.17; 95% CI: 1.06-1.30; p < 0.0001); catheter-associated urinary tract infection (CAUTI) acquisition (aOR = 1.34; 95% CI: 1.15-1.56; p < 0.0001); older age, rising risk 2% yearly (aOR = 1.02; 95% CI: 1.01-1.02; p < 0.0001); longer indwelling central line(CL)-days, rising risk 3% daily (aOR = 1.03; 95% CI: 1.02-1.03; p < 0.0001); longer indwelling urinary catheter(UC)-days, rising risk 1% daily (aOR = 1.01; 95% CI: 1.01-1.26; p < 0.0001); higher mechanical ventilation (MV) (aOR = 6.47; 95% CI: 5.96-7.03; p < 0.0001) and urinary catheter-utilization ratio (aOR = 1.19; 95% CI: 1.11-1.27; p < 0.0001); lower-middle level income country (aOR = 2.94; 95% CI: 2.10-4.12; p < 0.0001); private (aOR = 1.50; 95% CI: 1.27-1.77; p < 0.0001) or public hospital (aOR = 1.47; 95% CI: 1.24-1.74; p < 0.0001) compared with university hospitals; medical hospitalization instead of surgical (aOR = 1.67; 95% CI: 1.59-1.75; p < 0.0001); neurologic ICU (aOR = 4.48; 95% CI: 2.68-7.50; p < 0.0001); adult oncology ICU (aOR = 3.48; 95% CI: 2.14-5.65; p < 0.0001); and others. CONCLUSION: Some of the identified mortality RFs are unlikely to change, such as the income level of the country, facility ownership, hospitalization type, ICU type, and age. But some of the mortality RFs we found can be changed, and efforts should be made to reduce CL-days, UC-days, MV-utilization ratio, UC-utilization ratio, and lower VAPs and CAUTI rates.
BACKGROUND: The International Nosocomial Infection Control Consortium (INICC) has found a high ICU mortality rate in Latin America. METHODS: A prospective cohort study in 198 ICUs of 96 hospitals in 46 cities in 12 Latin American countries to identify mortality risk factors (RF), and data were analyzed using multiple logistic regression. RESULTS: Between 07/01/1998 and 02/12/2022, 71,685 patients, followed during 652,167 patient-days, acquired 4700 HAIs, and 10,890 died. We prospectively collected data of 16 variables. Following 11 independent mortality RFs were identified in multiple logistic regression: ventilator-associated pneumonia (VAP) acquisition (adjusted odds ratio [aOR] = 1.17; 95% CI: 1.06-1.30; p < 0.0001); catheter-associated urinary tract infection (CAUTI) acquisition (aOR = 1.34; 95% CI: 1.15-1.56; p < 0.0001); older age, rising risk 2% yearly (aOR = 1.02; 95% CI: 1.01-1.02; p < 0.0001); longer indwelling central line(CL)-days, rising risk 3% daily (aOR = 1.03; 95% CI: 1.02-1.03; p < 0.0001); longer indwelling urinary catheter(UC)-days, rising risk 1% daily (aOR = 1.01; 95% CI: 1.01-1.26; p < 0.0001); higher mechanical ventilation (MV) (aOR = 6.47; 95% CI: 5.96-7.03; p < 0.0001) and urinary catheter-utilization ratio (aOR = 1.19; 95% CI: 1.11-1.27; p < 0.0001); lower-middle level income country (aOR = 2.94; 95% CI: 2.10-4.12; p < 0.0001); private (aOR = 1.50; 95% CI: 1.27-1.77; p < 0.0001) or public hospital (aOR = 1.47; 95% CI: 1.24-1.74; p < 0.0001) compared with university hospitals; medical hospitalization instead of surgical (aOR = 1.67; 95% CI: 1.59-1.75; p < 0.0001); neurologic ICU (aOR = 4.48; 95% CI: 2.68-7.50; p < 0.0001); adult oncology ICU (aOR = 3.48; 95% CI: 2.14-5.65; p < 0.0001); and others. CONCLUSION: Some of the identified mortality RFs are unlikely to change, such as the income level of the country, facility ownership, hospitalization type, ICU type, and age. But some of the mortality RFs we found can be changed, and efforts should be made to reduce CL-days, UC-days, MV-utilization ratio, UC-utilization ratio, and lower VAPs and CAUTI rates.
Authors: Victor D Rosenthal; Dennis G Maki; Silom Jamulitrat; Eduardo A Medeiros; Subhash Kumar Todi; David Yepes Gomez; Hakan Leblebicioglu; Ilham Abu Khader; María Guadalupe Miranda Novales; Regina Berba; Fernando Martín Ramírez Wong; Amina Barkat; Osiel Requejo Pino; Lourdes Dueñas; Zan Mitrev; Hu Bijie; Vaidotas Gurskis; S S Kanj; Trudell Mapp; Rosalía Fernández Hidalgo; Nejla Ben Jaballah; Lul Raka; Achilleas Gikas; Altaf Ahmed; Le Thi Anh Thu; María Eugenia Guzmán Siritt Journal: Am J Infect Control Date: 2010-03 Impact factor: 2.918
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Authors: Victor D Rosenthal; Hu Bijie; Dennis G Maki; Yatin Mehta; Anucha Apisarnthanarak; Eduardo A Medeiros; Hakan Leblebicioglu; Dale Fisher; Carlos Álvarez-Moreno; Ilham Abu Khader; Marisela Del Rocío González Martínez; Luis E Cuellar; Josephine Anne Navoa-Ng; Rédouane Abouqal; Humberto Guanche Garcell; Zan Mitrev; María Catalina Pirez García; Asma Hamdi; Lourdes Dueñas; Elsie Cancel; Vaidotas Gurskis; Ossama Rasslan; Altaf Ahmed; Souha S Kanj; Olber Chavarría Ugalde; Trudell Mapp; Lul Raka; Cheong Yuet Meng; Le Thi Anh Thu; Sameeh Ghazal; Achilleas Gikas; Leonardo Pazmiño Narváez; Nepomuceno Mejía; Nassya Hadjieva; May Osman Gamar Elanbya; María Eugenia Guzmán Siritt; Kushlani Jayatilleke Journal: Am J Infect Control Date: 2011-09-10 Impact factor: 2.918
Authors: Víctor Daniel Rosenthal; Dennis George Maki; Yatin Mehta; Hakan Leblebicioglu; Ziad Ahmed Memish; Haifaa Hassan Al-Mousa; Hanan Balkhy; Bijie Hu; Carlos Alvarez-Moreno; Eduardo Alexandrino Medeiros; Anucha Apisarnthanarak; Lul Raka; Luis E Cuellar; Altaf Ahmed; Josephine Anne Navoa-Ng; Amani Ali El-Kholy; Souha Sami Kanj; Ider Bat-Erdene; Wieslawa Duszynska; Nguyen Van Truong; Leonardo N Pazmino; Lucy Chai See-Lum; Rosalia Fernández-Hidalgo; Gabriela Di-Silvestre; Farid Zand; Sona Hlinkova; Vladislav Belskiy; Hussain Al-Rahma; Marco Tulio Luque-Torres; Nesil Bayraktar; Zan Mitrev; Vaidotas Gurskis; Dale Fisher; Ilham Bulos Abu-Khader; Kamal Berechid; Arnaldo Rodríguez-Sánchez; Florin George Horhat; Osiel Requejo-Pino; Nassya Hadjieva; Nejla Ben-Jaballah; Elías García-Mayorca; Luis Kushner-Dávalos; Srdjan Pasic; Luis E Pedrozo-Ortiz; Eleni Apostolopoulou; Nepomuceno Mejía; May Osman Gamar-Elanbya; Kushlani Jayatilleke; Miriam de Lourdes-Dueñas; Guadalupe Aguirre-Avalos Journal: Am J Infect Control Date: 2014-09 Impact factor: 2.918
Authors: Victor D Rosenthal; Dennis G Maki; Ajita Mehta; Carlos Alvarez-Moreno; Hakan Leblebicioglu; Francisco Higuera; Luis E Cuellar; Naoufel Madani; Zan Mitrev; Lourdes Dueñas; Josephine Anne Navoa-Ng; Humberto Guanche Garcell; Lul Raka; Rosalía Fernández Hidalgo; Eduardo A Medeiros; Souha S Kanj; Salisu Abubakar; Patricio Nercelles; Ricardo Diez Pratesi Journal: Am J Infect Control Date: 2008-10-03 Impact factor: 2.918