Abstract
Introduction:
Older adults undergoing vascular surgery are particularly vulnerable to hospital-acquired infections (HAIs) due to frailty, multi-morbidity, and the high prevalence of emergency interventions. HAIs in this population significantly affect recovery, length of stay, and survival.
METHODS
We conducted a single-canter retrospective analysis of vascular inpatients aged ≥60 years that developed new HAIs during admission between 1st June 2020 and 31st July 2021. Patients with diabetic foot infections, pre-existing surgical site infections (SSIs), or Clostridium difficile were excluded.
RESULTS
943 Patients were admitted to our vascular center from over 14 months. Out of 157 new HAIs, 134 (85%) occurred in patients aged ≥60, with male predominance (54.5%). 111/ 134 (83%) followed emergency admissions while 23/134 (17%) cases were associated with elective admissions. 24/134 (18%) patients did not undergo active vascular intervention.
589 vascular procedures were performed across all admissions. 171 of them were carried out in the 134 admissions and were complicated by new (HAI).
- Group A (UTI/chest infections, 104/134 (78%); chest infections (55/104 = 53%) or UTI (35/104 = 34%) or both (14/104 = 13%). Their mean LOS was 29 days, and 30-day mortality was 30%. Mean hospital stay in Chest infections or UTI was not significantly different at 30 days and 31 days sequentially. Combined chest infection and UTI cases had significantly longer length of stay (42 days) compared to either chest infections or UTI (p < 0.001) with higher female LOS compared to males (49 vs. 32 days; p=0.02)
- Group B (non-UTI/chest HAIs, 30/134 (22%); they had bacteremia and Surgical Site Infections. The Mean LOS was 28 days; 30-day mortality was 16.7%
CONCLUSION
HAIs represent a major source of morbidity and mortality among older vascular inpatients, especially after emergency admissions. While UTIs and chest infections are the most frequent, SSIs and bacteremia carry the greatest morbidity and mortality