Author | Provenzano, Bruna Cuoco | |
Author | Bartholo, Thiago | |
Author | Ribeiro-Alves, Marcelo | |
Author | Santos, Ana Paula Gomes dos | |
Author | Mafort, Thiago Thomaz | |
Author | Castro, Marcos Cesar Santos de | |
Author | Oliveira, Jose Gustavo Pugliese de | |
Author | Bruno, Leonardo Palermo | |
Author | Lopes, Agnaldo José | |
Author | Costa, Claudia Henrique da | |
Author | Rufino, Rogerio | |
Access date | 2021-12-15T16:24:07Z | |
Available date | 2021-12-15T16:24:07Z | |
Document date | 2021 | |
Citation | PROVENZANO, Bruna Cuoco et al. The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital. Revista da Associacao Medica Brasileira, v. 67, n. 7, p. 997-1002, 2021 | pt_BR |
ISSN | 0104-4230 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/50449 | |
Language | eng | pt_BR |
Publisher | Scielo | pt_BR |
Rights | open access | pt_BR |
Title | The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital | pt_BR |
Type | Article | pt_BR |
DOI | 10.1590/1806-9282.20210433 | |
Abstract | Objective: This study aims to analyze the risk factors for in-hospital mortality in a cohort of patients admitted to a newly adapted intensive care unit in a public hospital in Rio de Janeiro.
Methods: This was an observational, retrospective, and descriptive study. Data were obtained from electronic medical records. Coronavirus disease 2019 (COVID-19) was diagnosed by detecting viral ribonucleic acid using reverse transcription polymerase chain reaction. Factors associated with the risk/protection from death were determined using the odds ratio and adjusted odds ratio.
Results: Fifty-one patients were admitted to the hospital. The median age of the patients was 63 years, 60% were male patients, and 54% were white patients. Sixty-seven percent of the patients were diagnosed with COVID-19. Sepsis at admission increased the chance of in-hospital death by 21 times (adjusted odds ratio=21.06 [0.79-555.2]; p=0.06). The strongest risk factor for death was the development of septic shock during hospitalization (adjusted odds ratio=98.56 [2.75-352.5]; p=0.01), and one in four patients had multidrug-resistant bacteria. Mechanical ventilation, vasopressors, neuromuscular blockers, and sedatives were also the risk factors for in-hospital mortality. The in-hospital mortality rate was 41%, and the mortality rate of patients on mechanical ventilation was 60%. The diagnosis of COVID-19 was not statistically related to the adverse outcomes.
Conclusions: In this cohort, the strongest risk factor for in-hospital death was the development of nosocomial septic shock. Healthcare-associated infections have a significant impact on mortality rates. Therefore, to have a better outcome, it is important to consider not only the availability of beds but also the way healthcare is delivered. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Pneumologia e Tisiologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Subject | SARS-CoV-2 | pt_BR |
Subject | COVID-19 | pt_BR |
Subject | Healthcare associated infection | pt_BR |
Subject | Mortality | pt_BR |
Subject | Patient safety | pt_BR |
xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |