Impact of infection on length of intensive care unit stay after intracerebral hemorrhage.
BACKGROUND
The vast majority of patients with intracerebral hemorrhage (ICH) are admitted to an intensive care unit (ICU). Patients admitted to ICUs have a high risk of developing nosocomial infections, while complicating infection appears to be associated with a longer ICU stay. An increased length of ICU stay translates directly into increased costs. The aim of this study was to assess the impact of a complicating infection on the length of ICU stay in patients with ICH.


METHODS
We studied 148 consecutive patients who were admitted to the ICU and diagnosed with spontaneous ICH. Complicating infection was defined as when a patient was treated with antibiotics for the diagnosis of an infectious disease after admission. The impacts of clinical factors on the length of ICU stay were assessed, including complicating infection, sex, age, Glasgow Coma Scale (GCS) score at admission, and surgical intervention.


RESULTS
The median ICU stay was 8 days (interquartile range, 3-18 days). Complicating infection occurred in 75 patients (51%). A multiple regression model for predicting the length of ICU stay was performed. After controlling for sex, age, GCS score, and surgical intervention, complicating infection was significantly associated with a longer ICU stay (P < 0.001). Surgical intervention was also an independent predictor (P < 0.001). The length of the ICU stay was significantly longer for patients with GCS scores of 6-8, compared to those with GCS scores of 13-15 (P = 0.01).


CONCLUSIONS
Complicating infection was an independent predictor of a prolonged ICU stay in patients with ICH.
Ohwaki
Kazuhiro
K
Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi, Tokyo, 173-8605, Japan. ns-waki@med.teikyo-u.ac.jp
Yano
Eiji
E
Nagashima
Hiroshi
H
Nakagomi
Tadayoshi
T
Tamura
Akira
A
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology*; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents