TUESDAY, May 18 (HealthDay News) -- Publicly reported ICU-acquired infection rates may be misleading, because there appears to be no link between self-reported incidence of infections and risk-adjusted mortality for high-risk patients, according to research presented May 17 at the annual international conference of the American Thoracic Society, held in New Orleans May 14-19, and published in the May issue of American Journal of Respiratory and Critical Care Medicine.
K.R. Courtright, M.D., of the University of Pennsylvania, Philadelphia, and colleagues used Pennsylvania hospital discharge data from 2006 linked to self-reported ventilator-associated pneumonia (VAP) and catheter-related blood stream infection (CRBSI) rates to determine adjusted 30-day mortality for patients undergoing central venous catheterization or invasive mechanical ventilation.
They found that the mean risk-adjusted mortality for patients on ventilators was 35.1 percent; for patients with central venous catheters, the risk was 26.9 percent. The incidence of these infections was not correlated with risk-adjusted mortality for either ventilator patients or patients with central venous catheters. After adjustment for hospital size and academic status, the lack of correlation remained.
"We found no correlation between self-reported incidence of VAP or
CRBSI and risk-adjusted mortality for at-risk patients. Publicly reporting ICU-acquired infection rates may fail to guide the public towards the hospitals with best overall performance, and reimbursement policies based on infection rates may actually penalize high performers," the authors write
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