Hyperbilirubinemia Predisposes to the Incidence of Nosocomial Infection
in Egyptian Patients with Cirrhosis: A cohort Study
Abstract
Background: nosocomial infection (NIs) is a major challenge in
healthcare facilities and has been associated with prolonged hospital
stay as well as increased morbidity and mortality. Aims: This research
aimed to estimate the impact of acute decompensation (AD) consequences
on the successive risk of nosocomial infections (NIs) and the go after
outcome. Methods: A total of 250 hospitalized cirrhotic patients with
decompensation were included in the study. Different decompensation
events and after-effects in patients with or without NIs were compared.
The logistic regression and Cox proportional hazards models were
designed for NIs development and mortality at 28 days, respectively.
Results: During hospitalization, 22.4 % of patients developed NIs.
Remarkably, a higher percentage of patients with NIs had jaundice
(42.9% vs. 26.8 %; p= 0.06 at admission compared to patients without
NIs, whilst a lower percentage had gastrointestinal hemorrhage (14.3 vs.
33.5%; p=0.017+). Multivariate analysis revealed that jaundice was
independently linked with the development of NIs (OR, 0.474; 95% CI:
0.24–0.92). The 28-day mortality rates of patients with NIs were
significantly higher than those without NIs (21.4 vs. 9%; p = 0.014).
According to the Cox proportional hazards model, jaundice stayed an
independent risk factor for 28-day death (HR,8.38; 95% CI:
3.58–19.62). Conclusion: Different decompensation events have different
impact on the incidence of Nosocomial infections. Jaundice is
independently associated with occurrence of NIs and increased 28-day
mortality. Therefore, prophylaxis measures are recommended to benefit
this specific subsection of patients. Keywords Decompensation,
nosocomial infections, jaundice, mortality, hospitalization