PMID- 37404257
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230718
IS  - 1178-6973 (Print)
IS  - 1178-6973 (Electronic)
IS  - 1178-6973 (Linking)
VI  - 16
DP  - 2023
TI  - Impact of Nosocomial Infection on in-Hospital Mortality Rate in Adult Patients 
      Under Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery.
PG  - 4189-4200
LID - 10.2147/IDR.S390599 [doi]
AB  - OBJECTIVE: There was no consensus on the impact of nosocomial infection on 
      In-hospital mortality rate in patients receiving ECMO. This study aimed to 
      investigate the impact of nosocomial infection (NI) on In-hospital mortality rate 
      in adult patients receiving venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) after cardiac surgery. MATERIALS AND METHODS: This retrospective study 
      included 503 adult patients who underwent VA-ECMO after cardiac surgery. The 
      impact of time-dependent NIs on In-hospital mortality rate within 28 days of ECMO 
      initiation was investigated using a Cox regression model. The cumulative 
      incidence function for death was compared between patients with NIs and those 
      without NIs using a competing risk model. RESULTS: Within 28 days after ECMO 
      initiation, 206 (41.0%) patients developed NIs, and 220 (43.7%) patients died. 
      The prevalence rates of NIs were 27.8% and 20.3% during and after ECMO therapy, 
      respectively. The incidence rates of NIs during and after ECMO therapy were 49 per thousand 
      and 25 per thousand, respectively. Time-dependent NI was an independent risk factor for 
      predicting death (hazard ratio = 1.05, 95% confidence interval = 1.00-1.11). The 
      cumulative incidence of death in patients with NI was significantly higher than 
      that in patients without NI at each time point within 28 days of ECMO initiation. 
      (Z = 5.816, P = 0.0159). CONCLUSION: NI was a common complication in adult 
      patients who received VA-ECMO after cardiac surgery, and time-dependent NI was an 
      independent risk factor for predicting mortality in these patients. Using a 
      competing risk model, we confirmed that NIs increased the risk of In-hospital 
      mortality rate in these patients.
CI  - (c) 2023 Li et al.
FAU - Li, Xiyuan
AU  - Li X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
AD  - Department of Intensive Care Unit, Aviation General Hospital of China Medical 
      University, Beijing, 100012, People's Republic of China.
FAU - Wang, Xiaomeng
AU  - Wang X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Wang, Liangshan
AU  - Wang L
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Li, Chenglong
AU  - Li C
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Hao, Xing
AU  - Hao X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Du, Zhongtao
AU  - Du Z
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Xie, Haixiu
AU  - Xie H
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Yang, Feng
AU  - Yang F
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Wang, Hong
AU  - Wang H
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
FAU - Hou, Xiaotong
AU  - Hou X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      100029, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20230628
PL  - New Zealand
TA  - Infect Drug Resist
JT  - Infection and drug resistance
JID - 101550216
PMC - PMC10315138
OTO - NOTNLM
OT  - Cox regression
OT  - competing risk model
OT  - in-hospital mortality rate
OT  - nosocomial infection
OT  - venoarterial extracorporeal membrane oxygenation
COIS- The authors report no conflicts of interest in this work.
EDAT- 2023/07/05 13:05
MHDA- 2023/07/05 13:06
PMCR- 2023/06/28
CRDT- 2023/07/05 10:34
PHST- 2022/09/26 00:00 [received]
PHST- 2023/05/30 00:00 [accepted]
PHST- 2023/07/05 13:06 [medline]
PHST- 2023/07/05 13:05 [pubmed]
PHST- 2023/07/05 10:34 [entrez]
PHST- 2023/06/28 00:00 [pmc-release]
AID - 390599 [pii]
AID - 10.2147/IDR.S390599 [doi]
PST - epublish
SO  - Infect Drug Resist. 2023 Jun 28;16:4189-4200. doi: 10.2147/IDR.S390599. 
      eCollection 2023.