Avaliação dos fatores de risco e mortalidade associados às infecções relacionadas à assistência à saúde, na unidade de terapia intensiva de um hospital universitário

Abstract

Healthcare-associated infections are a significant public health problem, especially in intensive care units, where critically ill patients are more vulnerable to infectious processes due to their clinical severity, the use of invasive devices, and prolonged hospitalization. This scenario contributes to increased morbidity and mortality, hospital costs, and the spread of multidrug-resistant microorganisms. Given this problem, the present study aimed to evaluate the risk factors and mortality associated with healthcare-associated infections in patients admitted to the intensive care unit of a university hospital. Method: This is a prospective observational cohort study with a quantitative approach, conducted with 77 patients hospitalized for more than 48 hours in an Intensive Care Unit. Data were collected from interviews with patients and information from medical records, organized in RedCap and analyzed in Python (version 3.13). Demographic and clinical variables were described and applied to normality tests, measures of central tendency, and dispersion. The association between IRAS, risk factors, and mortality was examined using relative risk and odds ratio. Results: It is evident that 34 patients developed healthcare-associated infections, with surgical site infection being the most common (10), followed by bloodstream infection (9) and urinary tract infection (9), as well as ventilator-associated pneumonia (6). A predominance of microorganisms such as Escherichia coli and Klebsiella pneumoniae was identified, in addition to a strong association between Healthcare-Associated Infections and prolonged hospitalization (13.5 days). Conclusion: The identified risk factors, presence of comorbidities, use of invasive devices, and prolonged hospitalization were statistically significant and proved to be determinants for the occurrence of healthcare-associated infections. Although the age variable was not statistically significant, a correlation with advanced age was observed, as well as a predominance of males among the affected patients. These risk factors directly influence clinical outcomes, reinforcing the need to strengthen prevention practices, epidemiological surveillance, clinical microbiology, and rational use of antimicrobials in intensive care units.