Nosocomial infection and risk factors in elderly patients in intensive care units

Abstract

Incidence of nosocomial infections gradually increase in patients over 65 years age population. There is a significant relationship between increased age and predisposition to nosocomial infections. Predisposition to infections in this age group is a result of impaired host defense, underlying chronic diseases, long-term hospitalization, steroids and immunosuppressive therapies and malnutrition. Nevertheless there is not much data about the incidence and risk factors of nosocomial infections in elderly population. In this study we aimed to investigate the incidence and risk factors for nosocomial infections and the factors affecting mortality rates in elderly patients in the medical intensive care units. Nosocomial infection is an important factor causes increased mortality rate and length of hospital stay. Mortality rates and time interval between admission and discharge is significantly higher in nosocomially infected group than others. There are several known independent risk factors for increased mortality rates include increased age and length of hospital stay, impaired conscious levels, co-morbidities, nosocomial infections, immunsupresive conditions such as malnutrition, malignancies, mechanic ventilation and/or central venous catheter usage. As a result nosocomial infection is an important and partially preventable risk factor for mortality among patients treated in intensive care units. Mechanical ventilation, central venous and/or urinary catheterizations are such invasive interventions that may cause higher nosocomial infection rates. In terms of decreasing nosocomial infection rates; less frequently used invasive interventions can help in achieving this purpose of treatment.

Keywords

• Nosocomial infection, elderly, intensive care unit, mortality, risk factors

Nosocomial infection and risk factors in elderly patients in intensive care units

Öz

65 yaş üzerindeki hastalarda nozokomiyal infeksiyon sıklığı her geçen gün artmaktadır ve ilerlemiş hasta yaşı ile nozokomiyal infeksiyon arasında belirgin bir ilişki bulunmaktadır. Bu hastalarda konak savunmasının azalması, altta yatan kronik hastalıklar, hastanede uzun yatış süresi, malnutrisyon, steroid ve immunsupresif kullanımı infeksiyona zemin hazırlayan diğer faktörlerdir. Maalesef yaşlı hastalarda ortaya çıkan nozokomiyal infeksiyonlar ve risk faktörleri ile ilgili literatürde çok fazla çalışma bulunmamaktadır. Bu çalışmada yoğun bakım ünitelerinde yatan yaşlı hastalarda ortaya çıkan nozokomiyal infeksiyonların risk faktörlerini ve mortalite üzerine olan etkilerini göstermeyi amaçladık.Nozokomiyal infeksiyonlar hastanede kalış süresini uzatan ve mortaliteyi artıran önemli bir etkendir. Mortalite oranları ve hastaneye yatış ile taburculuk arasında geçen süre nozokomiyal infeksiyonu olan hastalarda belirgin olarak daha fazladır. Yoğun bakım ünitelerinde, ileri yaş, hastanede uzun yatış süresi, altta yatan hastalıklar, nozokomiyal infeksiyonlar, immunsupresif durumlar, uygulanan invaziv girisimler mortaliteyi artıran bağımsız risk faktörleridir.Sonuc olarak nozokomiyal infeksiyonlar yoğun bakım hastaları icin mortalite üzerinde önemli etkisi olan ve kısmen önlenebilir bir risk faktörüdür. Uygulanan invaziv işlemlerin azaltılması bu infeksiyonlardan korunmada önemli bir rol oynamaktadır

Anahtar Kelimeler

• Nozokomiyal infeksiyon, yaşlı, yoğun bakım, mortalite, risk faktörleri

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