Patient Safety and Quality

Trauma patients with hospital-acquired infections have poor outcomes, including increased mortality risk

Among all hospital admissions, trauma patients are at especially high risk when it comes to developing hospital-acquired infections (HAIs). When these infections occur, they are a leading cause of death in these individuals. A new study found that trauma patients with HAIs have longer hospital stays, increased risk of dying, and higher inpatient costs.

The researchers examined the relationship between four different HAIs: sepsis, pneumonia, Staphylococcus infections, and Clostridium difficile-associated disease and three outcome measures: in-hospital mortality, length of hospital stay, and inpatient costs. They analyzed the records on 155,891 trauma patients obtained from the 2005 and 2006 Nationwide Inpatient Sample.

All three outcome measures were significantly higher in patients with HAIs than in trauma patients without these infections. Patients with sepsis had the highest risk of dying in the hospital, with close to a sixfold higher odds of mortality compared to patients without HAIs. Among the other infections, there was a 1.5- to 1.9-fold higher odds of dying in the hospital. When costs were analyzed, patients with HAIs had health care expenditures 2- to 2.5-fold higher compared with non-infected patients. Those with HAIs also stayed in the hospital twice as long as patients without HAIs. The researchers call for more patient safety initiatives to reduce HAIs and related poor outcomes in this patient population. The study was supported in part by the Agency for Healthcare Research and Quality (HS16737).

See "Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients," by Laurent G. Glance, M.D., Pat W. Stone, Ph.D., Dana B. Mukamel, Ph.D., and Andrew W. Dick, Ph.D., in the July 2011 Archives of Surgery 146(7), pp. 794-801.

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