Hepatitis C status and infectious complications in the surgical intensive care unit: a retrospective analysis of 1,941 consecutive patients
Kueht M, Bebko S, Helmick R, and Awad S. Hepatitis C status and infectious complications in the surgical intensive care unit: a retrospective analysis of 1,941 consecutive patients. Am J Surg 2016; 211(6):1064-1070.
American journal of surgery
BACKGROUND: Hepatitis C virus (HCV) infection is thought to be associated with immune dysfunction. We hypothesized that HCV status would be associated with increased infectious complications in the surgical intensive care unit (SICU).
METHODS: All patients admitted to our SICU between 2008 and 2012 were included. We evaluated 90-day mortality and infectious complications in the SICU. Multivariate logistic regression was performed to identify predictors of infectious complications and 90-day mortality.
RESULTS: A total of 1,941 patients were included. The HCV-positive group had a higher overall incidence of infectious complications (25% vs 18%), particularly ventilator-associated pneumonia (VAP) and bacteremia. The increased incidences of VAP and bacteremia persisted when cirrhotic patients were excluded. Prolonged intubation (Odds Ratio [OR] = 2.1), abdominal surgery (OR = 1.6), and model for end-stage liver disease ≥ 15 (OR = 1.4) were independent predictors of SICU infectious complications.
CONCLUSIONS: The HCV-positive group had an increased incidence of infectious complications in the SICU, particularly VAP and bacteremia. This effect persisted when cirrhotic patients were excluded.
Medical Subject Headings
Adult; Aged; Bacteremia; Cause of Death; Critical Care; Cross Infection; Databases, Factual; Female; Follow-Up Studies; Hepatitis C, Chronic; Hospital Mortality; Humans; Immunocompromised Host; Intensive Care Units; Logistic Models; Male; Middle Aged; Multivariate Analysis; Postoperative Complications; Retrospective Studies; Risk Assessment; Survival Rate; United States