Spatial Patterns in Hospital-Acquired Infections in Portugal (2014–2017)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Area
2.2. Study Design
2.3. Data Sources
2.4. Data Selection
2.5. Data Analysis
2.6. Ethics Statement
3. Results
3.1. Profiles of HAI Cases and Their Sociodemographic and Clinical Characteristics
3.2. Spatial Distribution of Hospitalization Rates by Municipality
4. Discussion
4.1. Spatial Asymmetries
4.2. Limitations
4.3. Implications and Future Work
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Hospital-Acquired Infections | ICD-9-CM Codes | ICD-10-CM Codes | ||||
---|---|---|---|---|---|---|
Catheter-related bloodstream infections | 038.12 | 038.11 | 041.11 | A41.01 | A41.02 | B95.61 |
041.12 | 996.62 | 999.3x | B95.62 | T80.2- | T82.7- | |
Infection by Clostridium difficile | 008.45 | A04.7- | ||||
Nosocomial Pneumonia | 480x | 481 | 482x | A48.1 | B01.2 | B05.2 |
483x | 485 | 486 | J10.0- | J11.0- | J12- | |
487.0 | 997.3x | J13 | J14 | J15- | ||
J16- | J17 | J18- | ||||
Surgical site infection | 483x | 485 | 486 | J10.0- | J11.0- | J12- |
487.0 | 569.61 | 682x | J13 | J14 | J15- | |
996.6x | 997.3x | 996.7x | J16- | J17 | J18- | |
998.5x | 998.6 | 999.34 | O86.0- | T81.4- | T81.8- | |
999.39 | T84.5 | T84.6 | T84.7 | |||
T88.0- | T88.8- | Z48.8- | ||||
Urinary tract infection | 590.1x | 590.2 | 590.8x | N10 | N15- | N16 |
590.9 | 595.0 | 595.4 | N30- | N30.81 | N39.0 | |
599.0 | 996.64 | 997.5 | N99.89 | T83.5- |
Age Category | ||||
---|---|---|---|---|
Characteristics | Total | Youth | Adults | Elderly |
Total HAI hospitalizations, n (%) | 318,218 (100.0) | 14,851 (4.7) | 57,700 (18.1) | 245,667 (77.2) |
Age, (years), Median, (IQR) | 79 (20.0) | 2 (7.0) | 54 (15.0) | 82 (11.0) |
Length of stay (LoS), (days), Median, (IQR) | 9 (10.0) | 6 (5.0) | 10 (11.0) | 10 (10.0) |
Sex, n (%) | ||||
Men | 158,552 (49.8) | 7921 (53.3) | 33,822 (58.6) | 116,809 (47.5) |
Women | 159,666 (50.2) | 6930 (46.6) | 23,878 (41.4) | 128,858 (52.5) |
Charlson comorbidity index, n (%) | ||||
0 | 80,401 (25.3) | 12,934 (87.1) | 22,736 (39.4) | 44,731 (18.2) |
1–2 | 137,858 (43.3) | 1751 (11.8) | 21,054 (36.5) | 115,053 (46.8) |
3–4 | 63,897 (20.1) | 110 (0.7) | 6868 (11.9) | 56,919 (23.2) |
>4 | 36,062 (11.3) | 56 (0.4) | 7042 (12.2) | 28,964 (11.8) |
Destination after discharge, n (%) | ||||
Residence | 248,069 (78.0) | 14,250 (96.0) | 48,349 (83.8) | 185,470 (75.5) |
Hospital transfer | 7484 (2.4) | 421 (2.8) | 2408 (4.2) | 4655 (1.9) |
Discharge against medical advice | 881 (0.3) | 23 (0.2) | 505 (0.9) | 353 (0.1) |
Transfer to continuous care | 11,697 (3.7) | 58 (0.4) | 1676 (2.9) | 9963 (4.1) |
Deceased | 50,087 (15.7) | 99 (0.7) | 4762 (8.3) | 45,226 (18.4) |
Admission type, n (%) | ||||
Scheduled | 17,916 (5.6) | 1280 (8.6) | 6525 (11.3) | 10,111 (4.1) |
Unplanned | 300,181 (94.4) | 13,569 (91.4) | 51,133 (88.6) | 235,479 (95.9) |
Others | 121 (0.0) | 2 (0.0) | 42 (0.1) | 77 (0.0) |
Admissions by NUT II, n (%) | ||||
North | 100,933 (31.7) | 4851 (32.7) | 19,922 (34.5) | 76,160 (31.0) |
Center | 87,719 (27.6) | 3266 (22.0) | 12,651 (21.9) | 71,802 (29.2) |
Lisboa Region | 94,190 (29.6) | 5422 (36.5) | 19,768 (34.3) | 69,000 (28.1) |
Alentejo | 22,944 (7.2) | 718 (4.8) | 3211 (5.6) | 19,015 (7.8) |
Algarve | 12,432 (3.9) | 594 (4.0) | 2148 (3.7) | 9690 (3.9) |
Hospital-acquired infections context 1 | ||||
Total, n (%) | 340,125 (100.0) | 15,074 (4.4) | 60,608 (17.8) | 264,443 (77.7) |
Catheter-related bloodstream infections | 19,581 (5.8) | 1448 (9.6) | 6435 (10.5) | 11,698 (4.4) |
Intestinal infection by Clostridium difficile | 3822 (1.1) | 49 (0.3) | 609 (1.0) | 3164 (1.2) |
Nosocomial pneumonia | 197,188 (58.0) | 10,957 (72.7) | 33,064 (54.6) | 153,167 (57.9) |
Surgical site infection | 11,883 (3.5) | 522 (3.5) | 5795 (9.6) | 5566 (2.1) |
Urinary tract infection | 107,651 (31.7) | 2098 (13.9) | 14,705 (24.3) | 90,848 (34.4) |
Hospital-Acquired Infections | Total n (%) | Alive n (%) | Deceased n (%) | IL (%) |
---|---|---|---|---|
Catheter-related bloodstream infections | 19,581 (5.8) | 16,845 (5.9) | 2736 (4.9) | 14.0 |
Infection by Clostridium difficile | 3822 (1.1) | 3186 (1.1) | 636 (1.1) | 16.6 |
Nosocomial pneumonia | 197,188 (58.0) | 160,762 (56.4) | 36,426 (65.8) | 18.5 |
Surgical site infection | 11,883 (3.5) | 11,296 (4.0) | 587 (1.1) | 5.0 |
Urinary tract infection | 107,651 (31.7) | 92,707 (32.6) | 14,944 (27.0) | 13.9 |
Hospital-Acquired Infections | 0 | 1–2 | 3–4 | >4 |
---|---|---|---|---|
Catheter-related bloodstream infections | 5398 (27.6) | 6964 (35.5) | 4101 (20.9) | 3128 (16.0) |
Infection by Clostridium difficile | 929 (24.3) | 1592 (41.7) | 823 (21.5) | 478 (12.5) |
Nosocomial pneumonia | 47,862 (24.3) | 90,414 (45.8) | 38,779 (19.7) | 20,133 (10.2) |
Surgical site infection | 6453 (54.3) | 3480 (29.3) | 948 (8.0) | 1002 (8.4) |
Urinary tract infection | 24,013 (22.3) | 45,178 (42.0) | 24,338 (22.6) | 14,122 (13.1) |
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Teixeira, H.; Freitas, A.; Sarmento, A.; Nossa, P.; Gonçalves, H.; Pina, M.d.F. Spatial Patterns in Hospital-Acquired Infections in Portugal (2014–2017). Int. J. Environ. Res. Public Health 2021, 18, 4703. https://doi.org/10.3390/ijerph18094703
Teixeira H, Freitas A, Sarmento A, Nossa P, Gonçalves H, Pina MdF. Spatial Patterns in Hospital-Acquired Infections in Portugal (2014–2017). International Journal of Environmental Research and Public Health. 2021; 18(9):4703. https://doi.org/10.3390/ijerph18094703
Chicago/Turabian StyleTeixeira, Hugo, Alberto Freitas, António Sarmento, Paulo Nossa, Hernâni Gonçalves, and Maria de Fátima Pina. 2021. "Spatial Patterns in Hospital-Acquired Infections in Portugal (2014–2017)" International Journal of Environmental Research and Public Health 18, no. 9: 4703. https://doi.org/10.3390/ijerph18094703