Proportion of hospital deaths potentially attributable to nosocomial infection.
OBJECTIVE
To determine the fraction of hospital deaths potentially associated with nosocomial infection (NI).


METHODS
A matched (1:1) case-control study.


METHODS
An 800-bed, tertiary-care, teaching hospital.


METHODS
All patients older than 14 years who were admitted to the hospital between January 1, 1990, and January 1, 1991, were eligible. All 524 consecutive deaths that occurred in the hospital comprised the case group. For each case, a control patient was matched for primary admission diagnosis and admission date.


METHODS
The proportion of hospital deaths potentially associated with NI was estimated from the population attributable risk (PAR) adjusted for age, gender, service, severity of illness, length of stay, and quality of the medical record.


RESULTS
For stays longer than 48 hours, the PAR for all NIs was estimated to be 21.3% (95% confidence interval [CI95], 16.8%-30.5%). The greatest proportion of deaths potentially associated with NIs was observed in patients with only one infection (PAR, 15.0%; CI95, 10.9%-22.6%) and bacteremia or sepsis (PAR, 7.7%; CI95, 4.6%-11.6%).


CONCLUSIONS
NIs are associated with a large proportion of intrahospital deaths. This information may help clinicians and healthcare managers to assess the impact of programs for the prevention and control of NIs on intrahospital death.
García-Martín
M
M
Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain.
Lardelli-Claret
P
P
Jiménez-Moleón
J J
JJ
Bueno-Cavanillas
A
A
Luna-del-Castillo
J D
JD
Gálvez-Vargas
R
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records / Q000592:standards; D008875:Middle Aged; D012107:Research Design; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology