Using competing risk and multistate model to estimate the impact of nosocomial infection on length of stay and mortality in burn patients in Southeast China

doi:10.1136/bmjopen-2017-020527

科研成果详情

题名	Using competing risk and multistate model to estimate the impact of nosocomial infection on length of stay and mortality in burn patients in Southeast China
作者	Guo, Hai-Lei1; Zhao, Guang-Ju2; Ling, Xiang-Wei1; Xu, Jian-Jun1; Lu, Cai-Jiao1; Liu, Zheng-Jun1
发表日期	2018-11
发表期刊	BMJ OPEN 影响因子和分区
语种	英语
原始文献类型	Article
关键词	burn nosocomial infection length of stay mortality multi-state model
其他关键词	INHALATION INJURY ; CARE ; IMMUNOSUPPRESSION ; EPIDEMIOLOGY ; PROBABILITY ; EXPERIENCE ; SURVIVAL ; OUTCOMES ; DEATH ; COST
摘要	Objective Due to the defects in skin barrier function and immune response, burn patients who survive the acute phase of a burn injury are at a high risk of nosocomial infection (NI). The aim of this study is to evaluate the impacts of NI on length of stay (LOS) and hospital mortality in burn patients using a multistate model. Design and setting A retrospective observational study was conducted in burn unit and intensive care unit in the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Participants Data were obtained from 1143 records of patients admitted with burn between 1 January 2013 and 31 December 2016. Methods Risk factors for NIs were determined by binary logistic regression. The extended Cox model with time-varying covariates was used to determine the impact of NIs on hospital mortality, and cumulative incidence functions were calculated. Multiple linear regression analysis was applied to detect the variables associated with LOS. Using a multistate model, the extra LOS due to NI were determined. Results 15.8% of total burn patients suffered from NIs and incidence density of NIs was 9.6 per 1000 patient-days. NIs significantly increased the rate of death (HR 4.266, 95% CI 2.218 to 8.208, p=0.000). The cumulative probability of death for patients with NI was greater that for those without NI. The extra LOS due to NIs was 17.68 days (95% CI 11.31 to 24.05). Conclusions Using appropriate statistical methods, the present study further illustrated that NIs were associated with the increased cumulative incidence of burn death and increased LOS in burn patients.
资助项目	National Natural Science FoundationNational Natural Science Foundation of China (NSFC) [81871583]; Wenzhou Municipal Science and Technology Project [Y2013010, 2015KYB239]
出版者	BMJ PUBLISHING GROUP
出版地	LONDON
ISSN	2044-6055
卷号	8 期号:11 页码:e020527.
DOI	10.1136/bmjopen-2017-020527
页数	7
WOS类目	Medicine, General & Internal
WOS研究方向	General & Internal Medicine
WOS记录号	WOS:000454740400010
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	30798283
PMC记录号	PMC6278804
SCOPUSEID	2-s2.0-85057722171
通讯作者地址	[Lu, Cai-Jiao]Department of Burns Surgery,First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
Scopus学科分类	Medicine (all)
引用统计	被引频次：5[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/13984
专题	附属第一医院_烧伤科附属第一医院_急诊科
通讯作者	Lu, Cai-Jiao
作者单位	1.Department of Burns Surgery,First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 2.Emergency Department,First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
第一作者单位	附属第一医院
通讯作者单位	附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	Guo, Hai-Lei,Zhao, Guang-Ju,Ling, Xiang-Wei,et al. Using competing risk and multistate model to estimate the impact of nosocomial infection on length of stay and mortality in burn patients in Southeast China[J]. BMJ OPEN,2018,8(11):e020527..
APA	Guo, Hai-Lei, Zhao, Guang-Ju, Ling, Xiang-Wei, Xu, Jian-Jun, Lu, Cai-Jiao, & Liu, Zheng-Jun. (2018). Using competing risk and multistate model to estimate the impact of nosocomial infection on length of stay and mortality in burn patients in Southeast China. BMJ OPEN, 8(11), e020527..
MLA	Guo, Hai-Lei,et al."Using competing risk and multistate model to estimate the impact of nosocomial infection on length of stay and mortality in burn patients in Southeast China".BMJ OPEN 8.11(2018):e020527..