Rosenthal, Victor Daniel and Jin, Zhilin and Rodrigues, Camilla and Myatra, Sheila Nainan and Divatia, Jigeeshu Vasishth and Biswas, Sanjay K. and Shrivastava, Anjana Mahesh and Kharbanda, Mohit and Nag, Bikas and Mehta, Yatin and Sarma, Smita and Todi, Subhash Kumar and Bhattacharyya, Mahuya and Bhakta, Arpita and Gan, Chin Seng and Low, Michelle Siu Yee and Kushairi, Marissa Madzlan and Chuah, Soo Lin and Wang, Qi Yuee and Chawla, Rajesh and Jain, Aakanksha Chawla and Kansal, Sudha and Bali, Roseleen Kaur and Arjun, Rajalakshmi and Davaadagva, Narangarav and Bat-Erdene, Batsuren and Begzjav, Tsolmon and Basri, Mat Nor Mohd and Tai, Chian-Wern and Lee, Pei-Chuen and Tang, Swee-Fong and Sandhu, Kavita and Badyal, Binesh and Arora, Ankush and Sengupta, Deep and Yin, Ruijie (2023) Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections. Infection Control & Hospital Epidemiology, 44 (8). pp. 1261-1266. ISSN 0899-823X, DOI https://doi.org/10.1017/ice.2022.245.
Full text not available from this repository.Abstract
Objective: To identify risk factors for mortality in intensive care units (ICUs) in Asia. Design: Prospective cohort study. Setting: The study included 317 ICUs of 96 hospitals in 44 cities in 9 countries of Asia: China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam. Participants: Patients aged >18 years admitted to ICUs. Results: In total, 157,667 patients were followed during 957,517 patient days, and 8,157 HAIs occurred. In multiple logistic regression, the following variables were associated with an increased mortality risk: central-line-associated bloodstream infection (CLABSI; aOR, 2.36; P < .0001), ventilator-associated event (VAE; aOR, 1.51; P < .0001), catheter-associated urinary tract infection (CAUTI; aOR, 1.04; P < .0001), and female sex (aOR, 1.06; P < .0001). Older age increased mortality risk by 1% per year (aOR, 1.01; P < .0001). Length of stay (LOS) increased mortality risk by 1% per bed day (aOR, 1.01; P < .0001). Central-line days increased mortality risk by 2% per central-line day (aOR, 1.02; P < .0001). Urinary catheter days increased mortality risk by 4% per urinary catheter day (aOR, 1.04; P < .0001). The highest mortality risks were associated with mechanical ventilation utilization ratio (aOR, 12.48; P < .0001), upper middle-income country (aOR, 1.09; P = .033), surgical hospitalization (aOR, 2.17; P < .0001), pediatric oncology ICU (aOR, 9.90; P < .0001), and adult oncology ICU (aOR, 4.52; P < .0001). Patients at university hospitals had the lowest mortality risk (aOR, 0.61; P < .0001). Conclusions: Some variables associated with an increased mortality risk are unlikely to change, such as age, sex, national economy, hospitalization type, and ICU type. Some other variables can be modified, such as LOS, central-line use, urinary catheter use, and mechanical ventilation as well as and acquisition of CLABSI, VAE, or CAUTI. To reduce mortality risk, we shall focus on strategies to reduce LOS; strategies to reduce central-line, urinary catheter, and mechanical ventilation use; and HAI prevention recommendations.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine |
| Divisions: | Universiti Malaya Medical Centre (UMMC) |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 12 Sep 2025 01:38 |
| Last Modified: | 12 Sep 2025 01:38 |
| URI: | http://eprints.um.edu.my/id/eprint/50531 |
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