The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital
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Publication Date: | 2021 |
Other Authors: | , , , , , , , , , |
Format: | Article |
Language: | eng |
Source: | Revista da Associação Médica Brasileira (Online) |
Download full: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000800997 |
Summary: | SUMMARY OBJECTIVE: This study aims to analyze the risk factors for in-hospital mortality in a cohort of patients admitted to a newly adapted intensive care unit in a public hospital in Rio de Janeiro. METHODS: This was an observational, retrospective, and descriptive study. Data were obtained from electronic medical records. Coronavirus disease 2019 (COVID-19) was diagnosed by detecting viral ribonucleic acid using reverse transcription polymerase chain reaction. Factors associated with the risk/protection from death were determined using the odds ratio and adjusted odds ratio. RESULTS: Fifty-one patients were admitted to the hospital. The median age of the patients was 63 years, 60% were male patients, and 54% were white patients. Sixty-seven percent of the patients were diagnosed with COVID-19. Sepsis at admission increased the chance of in-hospital death by 21 times (adjusted odds ratio=21.06 [0.79–555.2]; p=0.06). The strongest risk factor for death was the development of septic shock during hospitalization (adjusted odds ratio=98.56 [2.75–352.5]; p=0.01), and one in four patients had multidrug-resistant bacteria. Mechanical ventilation, vasopressors, neuromuscular blockers, and sedatives were also the risk factors for in-hospital mortality. The in-hospital mortality rate was 41%, and the mortality rate of patients on mechanical ventilation was 60%. The diagnosis of COVID-19 was not statistically related to the adverse outcomes. CONCLUSIONS: In this cohort, the strongest risk factor for in-hospital death was the development of nosocomial septic shock. Healthcare-associated infections have a significant impact on mortality rates. Therefore, to have a better outcome, it is important to consider not only the availability of beds but also the way healthcare is delivered. |
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The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospitalSARS-CoV-2COVID-19Healthcare associated infectionMortalityPatient safetySUMMARY OBJECTIVE: This study aims to analyze the risk factors for in-hospital mortality in a cohort of patients admitted to a newly adapted intensive care unit in a public hospital in Rio de Janeiro. METHODS: This was an observational, retrospective, and descriptive study. Data were obtained from electronic medical records. Coronavirus disease 2019 (COVID-19) was diagnosed by detecting viral ribonucleic acid using reverse transcription polymerase chain reaction. Factors associated with the risk/protection from death were determined using the odds ratio and adjusted odds ratio. RESULTS: Fifty-one patients were admitted to the hospital. The median age of the patients was 63 years, 60% were male patients, and 54% were white patients. Sixty-seven percent of the patients were diagnosed with COVID-19. Sepsis at admission increased the chance of in-hospital death by 21 times (adjusted odds ratio=21.06 [0.79–555.2]; p=0.06). The strongest risk factor for death was the development of septic shock during hospitalization (adjusted odds ratio=98.56 [2.75–352.5]; p=0.01), and one in four patients had multidrug-resistant bacteria. Mechanical ventilation, vasopressors, neuromuscular blockers, and sedatives were also the risk factors for in-hospital mortality. The in-hospital mortality rate was 41%, and the mortality rate of patients on mechanical ventilation was 60%. The diagnosis of COVID-19 was not statistically related to the adverse outcomes. CONCLUSIONS: In this cohort, the strongest risk factor for in-hospital death was the development of nosocomial septic shock. Healthcare-associated infections have a significant impact on mortality rates. Therefore, to have a better outcome, it is important to consider not only the availability of beds but also the way healthcare is delivered.Associação Médica Brasileira2021-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000800997Revista da Associação Médica Brasileira v.67 n.7 2021reponame:Revista da Associação Médica Brasileira (Online)instname:Associação Médica Brasileira (AMB)instacron:AMB10.1590/1806-9282.20210433info:eu-repo/semantics/openAccessProvenzano,Bruna CuocoBartholo,ThiagoRibeiro-Alves,MarceloSantos,Ana Paula Gomes dosMafort,Thiago ThomazCastro,Marcos Cesar Santos deOliveira,Jose Gustavo Pugliese deBruno,Leonardo PalermoLopes,Agnaldo JoséCosta,Claudia Henrique daRufino,Rogerioeng2021-10-19T00:00:00Zoai:scielo:S0104-42302021000800997Revistahttps://ramb.amb.org.br/ultimas-edicoes/#https://old.scielo.br/oai/scielo-oai.php||ramb@amb.org.br1806-92820104-4230opendoar:2021-10-19T00:00Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)false |
dc.title.none.fl_str_mv |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
title |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
spellingShingle |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital Provenzano,Bruna Cuoco SARS-CoV-2 COVID-19 Healthcare associated infection Mortality Patient safety |
title_short |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
title_full |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
title_fullStr |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
title_full_unstemmed |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
title_sort |
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital |
author |
Provenzano,Bruna Cuoco |
author_facet |
Provenzano,Bruna Cuoco Bartholo,Thiago Ribeiro-Alves,Marcelo Santos,Ana Paula Gomes dos Mafort,Thiago Thomaz Castro,Marcos Cesar Santos de Oliveira,Jose Gustavo Pugliese de Bruno,Leonardo Palermo Lopes,Agnaldo José Costa,Claudia Henrique da Rufino,Rogerio |
author_role |
author |
author2 |
Bartholo,Thiago Ribeiro-Alves,Marcelo Santos,Ana Paula Gomes dos Mafort,Thiago Thomaz Castro,Marcos Cesar Santos de Oliveira,Jose Gustavo Pugliese de Bruno,Leonardo Palermo Lopes,Agnaldo José Costa,Claudia Henrique da Rufino,Rogerio |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Provenzano,Bruna Cuoco Bartholo,Thiago Ribeiro-Alves,Marcelo Santos,Ana Paula Gomes dos Mafort,Thiago Thomaz Castro,Marcos Cesar Santos de Oliveira,Jose Gustavo Pugliese de Bruno,Leonardo Palermo Lopes,Agnaldo José Costa,Claudia Henrique da Rufino,Rogerio |
dc.subject.por.fl_str_mv |
SARS-CoV-2 COVID-19 Healthcare associated infection Mortality Patient safety |
topic |
SARS-CoV-2 COVID-19 Healthcare associated infection Mortality Patient safety |
description |
SUMMARY OBJECTIVE: This study aims to analyze the risk factors for in-hospital mortality in a cohort of patients admitted to a newly adapted intensive care unit in a public hospital in Rio de Janeiro. METHODS: This was an observational, retrospective, and descriptive study. Data were obtained from electronic medical records. Coronavirus disease 2019 (COVID-19) was diagnosed by detecting viral ribonucleic acid using reverse transcription polymerase chain reaction. Factors associated with the risk/protection from death were determined using the odds ratio and adjusted odds ratio. RESULTS: Fifty-one patients were admitted to the hospital. The median age of the patients was 63 years, 60% were male patients, and 54% were white patients. Sixty-seven percent of the patients were diagnosed with COVID-19. Sepsis at admission increased the chance of in-hospital death by 21 times (adjusted odds ratio=21.06 [0.79–555.2]; p=0.06). The strongest risk factor for death was the development of septic shock during hospitalization (adjusted odds ratio=98.56 [2.75–352.5]; p=0.01), and one in four patients had multidrug-resistant bacteria. Mechanical ventilation, vasopressors, neuromuscular blockers, and sedatives were also the risk factors for in-hospital mortality. The in-hospital mortality rate was 41%, and the mortality rate of patients on mechanical ventilation was 60%. The diagnosis of COVID-19 was not statistically related to the adverse outcomes. CONCLUSIONS: In this cohort, the strongest risk factor for in-hospital death was the development of nosocomial septic shock. Healthcare-associated infections have a significant impact on mortality rates. Therefore, to have a better outcome, it is important to consider not only the availability of beds but also the way healthcare is delivered. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-07-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000800997 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000800997 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1806-9282.20210433 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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text/html |
dc.publisher.none.fl_str_mv |
Associação Médica Brasileira |
publisher.none.fl_str_mv |
Associação Médica Brasileira |
dc.source.none.fl_str_mv |
Revista da Associação Médica Brasileira v.67 n.7 2021 reponame:Revista da Associação Médica Brasileira (Online) instname:Associação Médica Brasileira (AMB) instacron:AMB |
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Revista da Associação Médica Brasileira (Online) |
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Revista da Associação Médica Brasileira (Online) |
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Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB) |
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