Long-term outcomes from nosocomial infections in persons with spinal cord injuries and disorders.
BACKGROUND
Nosocomial infection may contribute to poor long-term consequences in persons who have spinal cord injuries and disorders (SCI&D).


METHODS
This is a cohort study of individuals who had SCI&D and were hospitalized at least once during 2002. They were followed for 3 years to assess inpatient (IP) admissions, total IP length of stay (LOS), outpatient (OP) visits, and mortality. Count data models and a Cox proportional hazards model were used to assess the relationship between previous infection and subsequent IP and OP use and long-term mortality, respectively.


RESULTS
Of persons who had SCI&D, 59% had at least one nosocomial infection. Multivariable regression indicated that veterans who had SCI&D had more IP admissions (b = 0.405; P < .0001) and longer IP LOS (b = 0.843; P < .0001) if they had a previous infection; however, infection status was not a predictor of future OP visits. Survival time was lower (913.93 versus 1034.75 days, P = .004) in the infection group. Death rate was higher in the nosocomial infection group (30.11% versus 10.77%; P = .004), but the association did not achieve significance in the Cox proportional hazards model (P = .12).


CONCLUSIONS
Nosocomial infections have serious subsequent consequences that result in future hospitalization and shorter survival. Efforts to prevent nosocomial infections are needed to reduce long-term adverse effects in persons who have SCI&D.
LaVela
Sherri L
SL
Spinal Cord Injury Quality Enhancement Research Initiative, Midwest Center for Health Services and Policy Research, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL 60141, USA. Sherri.LaVela@va.gov
Evans
Charlesnika T
CT
Miskevics
Scott
S
Parada
Jorge P
JP
Priebe
Michael
M
Weaver
Frances M
FM
D000293:Adolescent; D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000150:complications* / Q000401:mortality; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D013119:Spinal Cord Injuries / Q000150:complications* / Q000401:mortality; D014481:United States / Q000453:epidemiology; D014728:Veterans