title: Prevalence of major infections and adverse outcomes among hospitalized. ST-elevation myocardial infarction patients in Florida, 2006.
abstract: BACKGROUND
  ST-elevation myocardial infarction (STEMI) patients have risk factors and co-morbidities and require procedures predisposing to healthcare acquired infections (HAIs). As few data exist on the extent and consequences of infections among these patients, the prevalence, predictors, and potential complications of major infections among hospitalized STEMI patients at all Florida acute care hospitals during 2006 were analyzed.
  
  
  METHODS
  Sociodemographic characteristics, risk factors, co-morbidities, procedures, complications, and mortality were analyzed from hospital discharge data for 11, 879 STEMI patients age ≥ 18 years. We used multivariable logistic regression modeling to examine and adjust for multiple potential predictors of any infection, bloodstream infection (BSI), pneumonia, surgical site infection (SSI), and urinary tract infection (UTI).
  
  
  RESULTS
  There were 2,562 infections among 16.6% of STEMI patients; 6.2% of patients had ≥2 infections. The most prevalent HAIs were UTIs (6.0%), pneumonia (4.6%), SSIs (4.1%), and BSIs (2.6%). Women were at 29% greater risk, Blacks had 23% greater risk, and HAI risk increased 11% with each 5 year increase in age. PCI was the only protective major procedure (OR 0.81, 95% CI, 0.69-0.95, p < .05). HAI lengthened hospital stays. STEMI patients with a BSI were almost 5 times more likely (31.3% vs. 6.5%, p < .0001), and those with pneumonia were 3 times more likely (19.6% vs. 6.5%, p < .0001) to die before discharge.
  
  
  CONCLUSIONS
  The protective effect of PCI on risk of infection is likely mediated by its many benefits, including reduced length of hospitalizations.
authors: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B, Downs Blvd., Tampa, FL 33612, USA. mnash@health.usf.edu
authors: Michelle C
authors: MC
authors: Nash
authors: Joel A
authors: JA
authors: Strom
authors: Elizabeth B
authors: EB
authors: Pathak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D016896:Treatment Outcome; D055815:Young Adult