Article
The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital
Registro en:
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
0104-4230
10.1590/1806-9282.20210433
Autor
Provenzano, Bruna Cuoco
Bartholo, Thiago
Ribeiro-Alves, Marcelo
Santos, Ana Paula Gomes dos
Mafort, Thiago Thomaz
Castro, Marcos Cesar Santos de
Oliveira, Jose Gustavo Pugliese de
Bruno, Leonardo Palermo
Lopes, Agnaldo José
Costa, Claudia Henrique da
Rufino, Rogerio
Resumen
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.