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  • Title: [Dutch results of the European study of the prevalence of infections during intensive care (EPIIC). I. Who is at risk?].
    Author: Ibelings MS, Bruining HA.
    Journal: Ned Tijdschr Geneeskd; 1994 Nov 05; 138(45):2239-43. PubMed ID: 7969609.
    Abstract:
    OBJECTIVE: Evaluation of the point prevalence of infections acquired in an intensive care unit (ICU) and determination of risk factors for ICU patients. DESIGN: Descriptive study. SETTING: 78 Dutch ICUs. METHOD: Collecting data by detailed questionnaires for each patient admitted to one of the participating ICUs, on one specified day: April 29th, 1992. Follow-up lasted 6 weeks. RESULTS: Included in the study were 472 patients; 176 (37%) suffered from an infection, of which 74 (16%) was ICU-acquired. The most important risk factors were: a longer ICU stay (relative risk (RR) 4.23 (95% confidence interval: 3.32-5.40), 99.37 (22.26-434.50) and 146.79 (32.83-656.30) for ICU stays of 3-4 days, 1-2 and more than 3 weeks respectively, in comparison with 0-2 days), correlated with severity of disease (organ dysfunction) and more medical interventions (intubation, urine catheter). The ICU infection risk was lower after elective surgery than after ICU admission without surgery; after emergency surgery the ICU infection risk was higher. During follow-up 63 (14%) patients died. Patients suffering from an ICU infection had a higher mortality risk; the strongest prognostic factor in determining the mortality risk was the APACHE II score (RR: 13 (3.89-42.69) with a score between 16-26 and RR > 100 (7.67-1377.93) with score > 31). CONCLUSION: ICU-acquired infections are a serious problem. Programmes for infection prevention and control need to be adjusted.
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