title: Hepatitis C status and infectious complications in the surgical intensive care unit: a retrospective analysis of 1,941 consecutive patients.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection is thought to be associated with immune dysfunction. We hypothesized that HCV status would be associated with increased infectious complications in the surgical intensive care unit (SICU).
  
  
  METHODS
  All patients admitted to our SICU between 2008 and 2012 were included. We evaluated 90-day mortality and infectious complications in the SICU. Multivariate logistic regression was performed to identify predictors of infectious complications and 90-day mortality.
  
  
  RESULTS
  A total of 1,941 patients were included. The HCV-positive group had a higher overall incidence of infectious complications (25% vs 18%), particularly ventilator-associated pneumonia (VAP) and bacteremia. The increased incidences of VAP and bacteremia persisted when cirrhotic patients were excluded. Prolonged intubation (Odds Ratio [OR] = 2.1), abdominal surgery (OR = 1.6), and model for end-stage liver disease ≥ 15 (OR = 1.4) were independent predictors of SICU infectious complications.
  
  
  CONCLUSIONS
  The HCV-positive group had an increased incidence of infectious complications in the SICU, particularly VAP and bacteremia. This effect persisted when cirrhotic patients were excluded.
authors.affiliation: Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Electronic address: Kueht@bcm.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Kueht
authors.affiliation: Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Michael E. Debakey VA Medical Center, Department of Surgery/Critical Care, Houston, TX, USA.
authors.forename: Serge
authors.initials: S
authors.lastname: Bebko
authors.affiliation: Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Michael E. Debakey VA Medical Center, Department of Surgery/Critical Care, Houston, TX, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Helmick
authors.affiliation: Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Michael E. Debakey VA Medical Center, Department of Surgery/Critical Care, Houston, TX, USA.
authors.forename: Samir
authors.initials: S
authors.lastname: Awad
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D002423:Cause of Death; D003422:Critical Care; D003428:Cross Infection / Q000453:epidemiology* / Q000503:physiopathology; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D017052:Hospital Mortality; D006801:Humans; D016867:Immunocompromised Host; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D014481:United States
keywords: Cirrhosis; Critical care; Hepatitis C; Nosocomial infection