Meta analysis on risk factors for healthcare-associated infection in patients with acute myocardial infarction / 中国感染控制杂志

ABSTRACT

Objective To systematically evaluate risk factors for healthcare-associated infection(HAI)in patients with acute myocardial infarction(AMI).Methods Literatures about risk factors for HAI in AMI patients were re-trieved from PubMed,EMbase,the Cochrane Library,China Biological Medicine Disk (CBM),WanFang Data, China National Knowledge Infrastructure (CNKI),and VIP Database from the establishment of database to Decem-ber 2017,two independent researchers screened literatures,extracted data,and evaluated quality according to inclu-sion and exclusion criteria,then performed Meta analysis using RevMan 5.3 software.Results There are 12 litera-tures in accordance with the inclusion criteria,with a total sample size of 13 812 cases.According to Meta analysis, 12 risk factors were statistically significant (all P＜0.05)age (OR ,3.45 [95%CI ,1.02－7.95]),length of hos-pital stay(OR ,4.84 [95%C I ,2.47－7.14]),tracheal intubation (OR ,7.74 [95%CI ,3.73－9.02]),preventive use of antimicrobial agents (OR ,6.79 [95%CI ,2.38－9.45]),mechanical ventilation (OR ,2.98 [95%CI ,1.05－4.78]),urinary catheterization (OR ,3.56 [95%CI ,1.24－4.49]),heart failure(OR ,3.82 [95% CI ,2.53－5.74]),arrhythmia (OR ,2.47 [95%CI ,1.28－4.63]),diabetes (OR ,2.23 [95% CI ,1.62－3.27]),chronic obstructive pulmonary disease (OR,2.14 [95%CI ,1.83－3.91]),use of H2blockers (OR,2.61 [95%CI ,1.87－4.36]),and left ventricular ejection fraction＜30%(OR,2.98 [95%CI ,1.35－4.26]).The publication bias of each risk factor was analyzed,and the results showed that publication bias was not obvious.Conclusion Health care workers should timely identify the high-risk population for HAI,strictly adhere to indications of invasive procedure, standardize the disinfection and isolation system,strengthen the process management of aseptic technique,and ac-tively take preventive measures to reduce risk for HAI in AMI patients.