Spatial Patterns in Hospital-Acquired Infections in Portugal (2014-2017)

dc.creatorTeixeira, Hugo
dc.creatorFreitas, Alberto
dc.creatorSarmento, António
dc.creatorNossa, Paulo
dc.creatorGonçalves, Hernâni
dc.creatorPina, Maria de Fátima
dc.date2023-04-06T19:32:50Z
dc.date2023-04-06T19:32:50Z
dc.date2021
dc.date.accessioned2023-09-26T20:11:00Z
dc.date.available2023-09-26T20:11:00Z
dc.identifierTEIXEIRA, 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.
dc.identifier1661-7827
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/57707
dc.identifier10.3390/ijerph18094703
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8850690
dc.descriptionBackground: 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.
dc.formatapplication/pdf
dc.languageeng
dc.publisherPublisher of Open Access Journals
dc.rightsopen access
dc.subjectHospital-acquired infections
dc.subjectSpatial epidemiology
dc.subjectAge-standardized hospitalization rates
dc.subjectSpatial autocorrelation
dc.subjectPortugal
dc.titleSpatial Patterns in Hospital-Acquired Infections in Portugal (2014-2017)
dc.typeArticle


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