Intensive care unit acquired infection and organ failure |
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Authors: | Pierre Damas Didier Ledoux Monique Nys Mehran Monchi Patricia Wiesen Benoît Beauve Jean-Charles Preiser |
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Institution: | (1) Department of General Intensive Care, University Hospital Center, University of Liege, Domaine Universitaire du Sart-Tilman, 4000 Liege, Belgium;(2) Department of Anesthesia and Intensive Care, University Hospital Center, University of Liege, Domaine Universitaire du Sart-Tilman, 4000 Liege, Belgium |
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Abstract: | Objective To assess the temporal relationship between ICU-acquired infection (IAI) and the prevalence and severity of organ dysfunction
or failure (OD/F).
Design and setting Observational, single center study in a mixed intensive care unit of a university hospital.
Patients We analyzed 1,191 patients hospitalized for more than 2 days during a 2-year observation period: 845 did not acquire IAI,
306 of whom had infection on admission (IOA); 346 did acquire IAI, 125 of whom had IOA.
Measurements and results The SOFA score was calculated daily, both SOFAmax, the sum of the worst OD/F during the ICU stay, and SOFApreinf, the sum
of the worst OD/F existing before the occurrence of the first IAI. The SAPS II and SOFA score of the first 24 h were significantly
higher in patients with than in those without IAI. SOFApreinf of IAI patients was also higher than the SOFAmax of patients
without IAI both in patients with (12.1 ± 4.6 vs. 8.9 ± 4.7) and those without IOA (9.2 ± 4.0 vs. 6.7 ± 3.5). SOFApreinf represented
85.7% of the value of SOFAmax in patients with IAI. SOFApreinf increased significantly with the occurrence of sepsis, severe
sepsis, or septic shock during ICU stay. Severe sepsis and septic shock during ICU stay as well as SOFApreinf were part of
the factors associated with hospital mortality.
Conclusions IAI is significantly associated with hospital mortality; however, its contribution to OD/F is minor. Moreover, severity of
IAI seems to be related to previous health status.
This article is discussed in the editorial available at: . |
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Keywords: | ICU-acquired infection Sepsis Sequential Organ Failure Assessment Organ failure |
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