ABSTRACT
Introducción: las infecciones nosocomiales asociadas a dispositivos aumentan la morbilidad y mortalidad en las unidades de cuidado intensivo. Objetivo: evaluar si el carácter docente de una unidad de cuidado intensivo incrementa la incidencia de infecciones nosocomiales. Métodos: estudio de una cohorte prospectiva de pacientes de la base de datos del Grupo de Vigilancia Epidemiológica de las UCI de Colombia desde noviembre de 2007 hasta diciembre del 2009. Se evalúo la asociación del carácter docente y la presencia de cualquier infección nosocomial asociada a dispositivos por medio de análisis bivariado y mutivariado. Resultados: fueron estudiados 31 863 pacientes en varias ciudades. Se encontró una incidencia de infecciones nosocomiales asociadas a dispositivos de 5,2 %, siendo la más común la neumonía asociada al ventilador. El análisis bivariado encontró como factores de riesgo el carácter docente, puntaje del APACHE II, ingreso por trauma, intoxicación o enfermedad pulmonar, unidad de cuidado intensivo quirúrgica y se encontró diferencia entre las ciudades. Las variables que mostraron asociación con la presencia de infecciones nosocomiales asociadas a dispositivos en el análisis multivariado fueron: estar hospitalizado en la ciudad 1, 2, 4 ó 5, diagnóstico de ingreso de trauma y cirugía; pero no se encontró asociación con la característica docente de la unidad de cuidado intensivo. Conclusión: el carácter docente no se asocia con un aumento de la incidencia de infecciones nosocomiales asociadas a dispositivos en las unidades de cuidado intensivo.
Device-Associated Nosocomial Infections (DANI) increase morbidity and mortality in intensive care units (ICU). The presence of students can theoretically increase the risk of such infections. Objective: The objective of this trial was to assess whether or not being a teaching hospital increases the incidence of DANI at ICU. Method: Prospective cohort study from the GRUVECO (Colombian National Group of Infection Surveillance) database since November 2007 to December 2009. We evaluated the association of academic nature and the presence of any DANI through bivariate and multivariate analysis. Results: A total of 31.863 patients were studied. The incidence of DANI was 5.2%, mainly ventilator-associated pneumonia Bivariated analysis demonstrated that risk factors for DANI were: academic ICUs, APACHE II score, admission for trauma, poisoning or lung disease and surgical ICUs; differences among geographic locations were also noticed. Variables associated with DANI in the multivariated analysis were: city 1, city 2, city 7 or city 4 and diagnosis of trauma or surgery, but no association was found with academic nature of ICU. Conclusions: Academic ICUs were not associated with increased incidence of DANI.
ABSTRACT
BACKGROUND: Most of blood components in Korea have been used at training hospitals. For representing more advanced supplying modalities about an effective usage of blood components, all blood components which were supplied by the Korean Red Cross (KRC) and used in training hospitals were surveyed and analyzed in 2000. METHOD: The data about blood collection and distribution were based on statistical yearbook of KRC and the data of blood components used and discarded was analyzed by survey from 222 training hospitals, which belong to the Korean Hospital Association. Result : The amounts of red blood cells (RBCs), fresh frozen plasmas (FFP) and platelet concentrates (PC) supplied by KRC at 2000 year were 1,554,855 units, 575,760 units and 1,151,919 units, respectively. Among total blood units supplied by KRC, 1,264,724 units of RBCs (81.3%), 516,506 units of FFP (89.7%) and 1,038,447 units of PCs (90.1%) were used at 222 training hospitals. The usage of blood components in each region was concentrated on metropolitan cities, and particularly 56.9% of RBCs, 62.5% of FFP and 62.9% of PCs were used in 3 regions (Seoul, Pusan and Kyunggido). CONCLUSION: Since the usage of blood components in Korea was concentrated on few number of metropolitan cities, it is not easy to supply appropriately for the demand of each regional blood center. For further effective blood supplies, development of more advanced blood transportation system should be attempted : Sharing of information about blood demands, an efficient supplying of blood components, shortening time and preventing accidents during the transport of them.