| Author | Teixeira, Hugo | |
| Author | Freitas, Alberto | |
| Author | Sarmento, António | |
| Author | Nossa, Paulo | |
| Author | Gonçalves, Hernâni | |
| Author | Pina, Maria de Fátima | |
| Access date | 2023-04-06T19:32:50Z | |
| Available date | 2023-04-06T19:32:50Z | |
| Document date | 2021 | |
| Citation | TEIXEIRA, Hugo et al. Spatial Patterns in Hospital-Acquired Infections in Portugal (2014–2017). International Journal of Environmental Research and Public Health, v. 18, n. 5, p. 1-18, 2021. | en_US |
| ISSN | 1661-7827 | |
| URI | https://www.arca.fiocruz.br/handle/icict/57707 | |
| Language | eng | en_US |
| Publisher | Publisher of Open Access Journals | en_US |
| Rights | open access | en_US |
| Title | Spatial Patterns in Hospital-Acquired Infections in Portugal (2014-2017) | en_US |
| Type | Article | en_US |
| DOI | 10.3390/ijerph18094703 | |
| Abstract | Background: Hospital-Acquired Infections (HAIs) represent the most frequent adverse
event associated with healthcare delivery and result in prolonged hospital stays and deaths worldwide. Aim: To analyze the spatial patterns of HAI incidence from 2014 to 2017 in Portugal. Methods:
Data from the Portuguese Discharge Hospital Register were used. We selected episodes of patients
with no infection on admission and with any of the following HAI diagnoses: catheter-related bloodstream infections, intestinal infections by Clostridium difficile, nosocomial pneumonia, surgical site
infections, and urinary tract infections. We calculated age-standardized hospitalization rates (ASHR)
by place of patient residence. We used empirical Bayes estimators to smooth the ASHR. The Moran
Index and Local Index of Spatial Autocorrelation (LISA) were calculated to identify spatial clusters.
Results: A total of 318,218 HAIs were registered, with men accounting for 49.8% cases. The median
length of stay (LOS) was 9.0 days, and 15.7% of patients died during the hospitalization. The peak of
HAIs (n = 81,690) occurred in 2015, representing 9.4% of the total hospital admissions. Substantial
spatial inequalities were observed, with the center region presenting three times the ASHR of the
north. A slight decrease in ASHR was observed after 2015. Pneumonia was the most frequent HAI in
all age groups. Conclusion: The incidence of HAI is not randomly distributed in the space; clusters of
high risk in the central region were seen over the entire study period. These findings may be useful
to support healthcare policymakers and to promote a revision of infection control policies, providing
insights for improved implementation. | en_US |
| Affilliation | University of Porto. Faculty of Medicine. Department of Community Medicine, Information and Health Decision Sciences. Porto, Portugal / University of Porto. Faculty of Medicine. Center for Health Technology and Services Research. Porto, Portugal / Universidade do Porto. Instituto de Engenharia Biomédica. Porto, Portugal / Universidade do Porto. Instituto de Investigação e Inovação em Saúde. Porto, Portugal. | en_US |
| Affilliation | University of Porto. Faculty of Medicine. Department of Community Medicine, Information and Health Decision Sciences. Porto, Portugal / University of Porto. Faculty of Medicine. Center for Health Technology and Services Research. Porto, Portugal. | en_US |
| Affilliation | Universidade do Porto. Instituto de Engenharia Biomédica. Porto, Portugal / Universidade do Porto. Instituto de Investigação e Inovação em Saúde. Porto, Portugal / Universitário de São João. Centro Hospitalar. Department of Infectious Diseases. Porto, Portugal. | en_US |
| Affilliation | University of Coimbra. Centre of Studies in Geography and Spatial Planning. Coimbra, Portugal / University of Coimbra. Department of Geography and Tourism. Coimbra, Portugal. | en_US |
| Affilliation | University of Porto. Faculty of Medicine. Department of Community Medicine, Information and Health Decision Sciences. Porto, Portugal / University of Porto. Faculty of Medicine. Center for Health Technology and Services Research. Porto, Portugal. | en_US |
| Affilliation | Universidade do Porto. Instituto de Engenharia Biomédica. Porto, Portugal / Universidade do Porto. Instituto de Investigação e Inovação em Saúde. Porto, Portugal / Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil. | en_US |
| Subject | Hospital-acquired infections | en_US |
| Subject | Spatial epidemiology | en_US |
| Subject | Age-standardized hospitalization rates | en_US |
| Subject | Spatial autocorrelation | en_US |
| Subject | Portugal | en_US |
