Prevalence of major infections and adverse outcomes among hospitalized. ST-elevation myocardial infarction patients in Florida, 2006

Abstract

BackgroundST-elevation myocardial infarction (STEMI) patients have risk factors and co-morbidities and require procedures predisposing to healthcare acquired infections (HAIs). As few data exist on the extent and consequences of infections among these patients, the prevalence, predictors, and potential complications of major infections among hospitalized STEMI patients at all Florida acute care hospitals during 2006 were analyzed.MethodsSociodemographic characteristics, risk factors, co-morbidities, procedures, complications, and mortality were analyzed from hospital discharge data for 11, 879 STEMI patients age ≥18 years. We used multivariable logistic regression modeling to examine and adjust for multiple potential predictors of any infection, bloodstream infection (BSI), pneumonia, surgical site infection (SSI), and urinary tract infection (UTI).ResultsThere were 2, 562 infections among 16.6% of STEMI patients; 6.2% of patients had ≥2 infections. The most prevalent HAIs were UTIs (6.0%), pneumonia (4.6%), SSIs (4.1%), and BSIs (2.6%). Women were at 29% greater risk, Blacks had 23% greater risk, and HAI risk increased 11% with each 5 year increase in age. PCI was the only protective major procedure (OR 0.81, 95% CI, 0.69-0.95, p < .05). HAI lengthened hospital stays. STEMI patients with a BSI were almost 5 times more likely (31.3% vs. 6.5%, p < .0001), and those with pneumonia were 3 times more likely (19.6% vs. 6.5%, p < .0001) to die before discharge.ConclusionsThe protective effect of PCI on risk of infection is likely mediated by its many benefits, including reduced length of hospitalizations.

Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study

“…Annually, HAIs affect 5-10% of all inpatients and 25% of ICU patients. A study investigating the prevalence and clinical impact of major infections among 11,879 hospitalized STEMI patients in Florida, during 2006, showed that infections were present in 16% of those patients [27]. The most prevalent HAIs were urinary tract infections, pneumonia, surgical site infections, and bloodstream infections [27].…”

“…A study investigating the prevalence and clinical impact of major infections among 11,879 hospitalized STEMI patients in Florida, during 2006, showed that infections were present in 16% of those patients [27]. The most prevalent HAIs were urinary tract infections, pneumonia, surgical site infections, and bloodstream infections [27]. The risk of infections was increased by comorbidities, AKI, AHF, major surgical procedures, and indwelling catheters, among other factors.…”

“…The risk of infections was increased by comorbidities, AKI, AHF, major surgical procedures, and indwelling catheters, among other factors. HAIs in STEMI patients resulted in prolonged hospital stays and adverse clinical outcomes, including in-hospital mortality [27].…”

Prognostic Factors for In-Hospital and Long-Term Survival in Patients with Acute ST-Segment Elevation Myocardial Infarction after Percutaneous Coronary Intervention

“…tors decline with age resulting in a weakened immune system and may explain why older patients are more prone to infections and thus have a worse prognosis for PCI (Nash et al 2011;Truffa et al 2012). Patients with T2DM are prone to malnutrition and disordered metabolism of sugar, protein and other important nutrients.…”

“…This is especially the case for patients with a Killip class III or higher (Shiraishi et al 2014). The GRACE risk score is a widely used prognostic scale for acute coronary syndrome and it has been shown to be a meaningful prognostic factor for in-hospital mortality in patients with STEMI (Nassar Junior et al 2013). …”