Table 3: Relative risks (RR) for infection, with 95% confidence intervals (CI), based on multivariate Cox regression. VAP CR‐BSI CA‐UTI RR 95% CI RR 95% CI RR 95% CI Sex Male Female 1 0.8* (0.6‐1.0) 1 1.4* (1.0‐1.8) APACHE II score 0‐19 ≥20 1 1.2 (1.0‐1.5) Immunity Not impaired Leucopenia Otherwise impaired immunity 1 ‡ 2.5** (1.5‐4.0) Admission Planned Acute Interaction with time 1 0.5** (0.3‐1.0) 1 1.8* 0.9** (1.0‐3.3) (0.9‐1.0) SDD use no SDD‐use SDD use 1 0.6** (0.4‐0.9) Systemic antibiotics at admission no SAB use SAB use 1 0.5** (0.3‐1.0) * 0.05 < p < 0.1 ** p < 0.05 ‡ No cases in category Analysis of risk factors for which interaction with time was significant was executed with interaction terms included for all categories. However only significant interactions are shown. DISCUSSION This is one of the few prospective studies to investigate both the incidence of and the risk factors for different types of device‐related ICU‐acquired infections as well as their effect on mortality in the same patient population. Nearly every fifth ventilated patient without a preexisting infection, admitted for 48 hours or more at Dutch ICUs developed VAP. Infection rates in patients with a CVC or CAD were 3% and 8% respectively. Longer device use increased the risk of acquiring an infection, especially CR‐BSI, and CA‐UTI. Device‐ associated infections did not significantly increase the mortality of device‐assisted patients after adjustment for case‐mix. Device utilization rates and infection rates Device use was high in our population. The overall mean ventilator use rate reported by the NNIS was approximately 40% [9] whereas this was 58% in our study. The same applies for central line use (approx. 50% and 61%, respectively) and urinary catheter use 2 29 Device-associated infections and associated mortality in the ICU
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