Tjallie van der Kooi

Q10b Please describe nature of competing cause: Contribution of HAI to death of the patient Appropriate treatment of a HAI affects the survival of the patient. However, here we do not consider the treatment. I.e. we do not distinguish between e.g. patients that die of a very severe HAI that could not be helped and a less severe HAI that, with better treatment, would not have led to the death of the patient. In both cases the HAI contributed to the death of the patient. Appropriate treatment can (in part) be addressed with the subsequent questions on adequate antimicrobial therapy and contribution of antimicrobial resistance. 3 Category scale O No contribution O Possibly O Definitely O Unknown/not verified Fit of 3 Category scale How well did the 3 Category scale apply? O Applies well O Applies reasonably O Applies poorly O Does not apply In combination with 3 Category scale: Major / Minor cause If HAI contributed possibly/definitely to death: ‐ HAI was a major cause: cause or part of sequence of events that led to death ‐ HAI was a minor cause: not the cause or part of the sequence of events that led to death, but added to the risk of death O Major cause O Minor cause Fit_major/minor O Applies well O Applies reasonably O Applies poorly O Does not apply 10 Points scale (Score 0 to 10) (0 = No contribution of HAI at all 10 = HAI definitely cause of death) Score: O Unknown/not verified Fit of 10 Points scale How well did the 10‐Points scale apply? O Applies well O Applies reasonably O Applies poorly O Does not apply WHO Scale These categories are evaluated for its use in the present setting. There is no need to check or align with what was indicated on the actual death certificates of the patients. O HAI did not contribute to the death or contribution was redundant (patient would have died anyway). O HAI was a contributory cause but not related to disease or condition causing death O HAI part of causal sequence but not sufficient on its own to cause death 6 129 Mortality review reproducibility study

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