Impact of Nosocomial Infection on Length of Stay and Functional Improvement Among Patients Admitted to an Acute Rehabilitation Unit
| Autor: | B. Lauren Young, Susan Goodnough, Joseph M. Mylotte, Robin P. Graham, Lucinda Kahler |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Epidemiology medicine.medical_treatment Urinary system New York Rehabilitation Centers Cohort Studies Internal medicine Activities of Daily Living Severity of illness medicine Humans Prospective Studies Hospitals Teaching Intensive care medicine Prospective cohort study Spinal cord injury Spinal Cord Injuries Cross Infection Rehabilitation Hospitals Public business.industry Recovery of Function Length of Stay medicine.disease Functional Independence Measure Infectious Diseases Linear Models Population study Female business Hospital Units |
| Zdroj: | Infection Control & Hospital Epidemiology. 22:83-87 |
| ISSN: | 1559-6834 0899-823X 0195-9417 |
| DOI: | 10.1086/501868 |
| Popis: | Objective:To identify factors predictive of length of stay (LOS) and the level of functional improvement achieved among patients admitted to an acute rehabilitation unit for the first time, with special reference to the role of nosocomial infection.Setting:A 40-bed acute rehabilitation unit within a 300-bed, tertiary-care, public, university-affiliated hospital.Study Population:All patients admitted to the unit between January 1997 and July 1998.Design:Prospective cohort study in which demographic and clinical data, including occurrence of nosocomial infection, were collected during the entire unit admission of each patient. Multivariate linear regression analysis was used to identify factors predictive of unit LOS or improvement in functional status as measured by the change in the Functional Independence Measure (FIM) score between admission and discharge (ΔFIM).Results:There were 423 admissions to the rehabilitation unit during the study period, of which 91 (21.5%) had spinal cord injury (SCI) as a principal diagnosis. One hundred seven nosocomial infections occurred during 84 (19.9%) of the 423 admissions. The most common infections were urinary tract (31.8% of all infections), surgical-site (18.5%), andClostridium difficilediarrhea (15%). Only one patient died of infection. After controlling for severity of illness on admission, functional status on admission, age, and other clinical factors, the significant positive predictors of unit LOS were as follows: SCI (PPConclusions:Several variables were identified as contributing to a longer LOS or to a smaller improvement in functional status among patients admitted for the first time to an acute rehabilitation unit Of these variables, only nosocomial infection has the potential for modification. Studies of new approaches to prevent infections among patients undergoing acute rehabilitation should be pursued. |
| Databáze: | OpenAIRE |
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