The Relationship Between Mortality and Hospital-Acquired Infections in Patients Followed-up with Neurological Complaints in the Third Level Intensive Care Unit

Abstract

Aim: We aimed to evaluate the demographic characteristics of patients with neurological complaints in Level III Intensive Care Unit (ICU) and hospital-acquired infection rate, isolated pathogen factors and regional distribution of them, relationship with invasive device use, and mortality rates. Material and Methods: 176 patients who were followed up in ICU within 12 months were included in the study. The demographic information, analysis, culture results of the patients, consultation notes of the infection committee doctors, and nurse observation charts were examined and the data of the patients were collected. Results: 46 of the 176 patients was died included in the present study died. The mortality rate was determined 26.13%. A total of 38 hospital-acquired infections (HAI) attacks were detected in 33 of all patients due to some of the patients have more than one attack. In addition, the rate of HAI was found as 21.59%. Central venous catheter-related bloodstream infections (CRBSI) in 2 patients (6.06%), mechanical ventilator independent pneumonia in 6 patients (18.1%), mechanical ventilator-associated pneumonia (VAP) or ventilator-associated tracheobronchitis (VAT) was detected in 11 patients (33.3%) and urinary tract infection (UTI) was found in 14 patients (42.4%). The most common hospital-acquired pneumonia (HAP) was urinary tract infection (UTI). It was observed that Acinetobacter baumannii was detected as the most common cause of pneumonia, and Escherichia coli was detected as the most common cause of urinary tract infection. Whereas, the mortality rate was found as 60.60% (20 of 33) in patients with HAI attack, this ratio was found as 18.18% (26 of 143) in patients without HAI attack. Conclusion: In patients who followed up with neurological complaints in the ICU, it was determined that having a HAI, recurrent HAI attacks, and ventilator associated pneumonia (VAP) or ventilator associated tracheobronchitis (VAT) increased mortality. Every physician who follows a patient in the ICU should evaluate the pathogen factors and infection rates in patients in his / her unit, and compare them with national and international data. By knowing infection surveillance data in ICUs, effective empirical treatment can be provided until the exact HAI pathogen is known. Knowing and effectively treating HAI data in ICU affects the prognosis, cost, and mortality rate of primary neurological disease by lowering HAI rates.

Keywords

• neurology intensive care unit
• hospital-acquired infection
• infection control

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