Factors related to hospital stay among patients with nosocomial infection acquired in the intensive care unit.
OBJECTIVE
To assess the influence of nosocomial infection on length of stay in the intensive care unit (ICU) and to determine the relative effect of other factors on extra length of hospitalization associated with nosocomial infection.


METHODS
Prospective cohort multicenter study in the context of the ENVIN-UCI project.


METHODS
Medical or surgical ICUs of 49 different hospitals in Spain.


METHODS
All consecutive patients (N = 6,593) admitted to ICUs of the participating hospitals who stayed for more than 24 hours during a 3-month period (from January 15 to April 15, 1996) were included. Length of ICU stay was compared between patients with and without nosocomial infections. RESULTS Uninfected patients (N = 5,868) had a median stay in the ICU of 3 days, whereas the median for infected patients (N = 725) was 17 days (P < .001). The median for infected patients with one episode of nosocomial infection was 13 days. The greatest length of stay (40 days) was among patients admitted to the ICU because of medical diseases, with an infection acquired before admission to the ICU, and with the largest number of nosocomial infection episodes. In extended stays, nosocomial infection was significantly associated with length of hospitalization (day 21; odds ratio, 22.38; 95% confidence interval 16.6 to 30.4), whereas an effect of variables related to severity of illness on admission (Acute Physiology and Chronic Health Evaluation II score, urgent surgery, and infection prior to ICU admission) was not found.


CONCLUSIONS
The presence of nosocomial infection and the number of infection episodes were the variables with the strongest association with prolonged hospital stay among ICU patients.
Olaechea
Pedro M
PM
Intensive Care Unit, Hospital de Galdakao, Bizkaia, Spain.
Ulibarrena
Miguel-Angel
MA
Alvarez-Lerma
Francisco
F
Insausti
Jesuś
J
Palomar
Mercedes
M
De la Cal
Miguel-Angel
MA
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003428:Cross Infection / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013514:Surgical Procedures, Operative