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The Association between Age, Sex, and Hospital-Acquired Infection Rates: Results from the 2009-2011 National Medicare Patient Safety Monitoring System

Published online by Cambridge University Press:  10 May 2016

Sheila Eckenrode ,
Anila Bakullari ,
Mark L. Metersky ,
Yun Wang ,
Michelle M. Pandolfi ,
Deron Galusha ,
Lisa Jaser  and
Noel Eldridge
Sheila Eckenrode
Affiliation:
Qualidigm, Wethersfield, Connecticut
Anila Bakullari
Affiliation:
Qualidigm, Wethersfield, Connecticut
Mark L. Metersky
Affiliation:
Qualidigm, Wethersfield, Connecticut Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, Connecticut
Yun Wang
Affiliation:
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
Michelle M. Pandolfi
Affiliation:
Qualidigm, Wethersfield, Connecticut
Deron Galusha
Affiliation:
Qualidigm, Wethersfield, Connecticut Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
Lisa Jaser
Affiliation:
Pharmacy, Griffin Hospital, Derby, Connecticut
Noel Eldridge
Affiliation:
Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland
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Objective.

To define the relationships between age, sex and hospital-acquired infection (HAI) rates in a national cohort of hospitalized patients.

Methods.

Analysis of chart-abstracted Medicare Patient Safety Monitoring System data from randomly selected medical records of patients hospitalized between January 1, 2009, and December 31, 2011, for acute cardiovascular disease, pneumonia, or major surgery associated with 1 of 6 HAIs. Patients were stratified into 6 groups. We then analyzed the association of age, sex, and 2 outcomes; the rate of occurrence of HAI for patients who were at risk and the rate of patients having at least 1 HAI.

Results.

Among 85,461 patients, all groups except younger female surgical patients had higher catheter-associated urinary tract infection (CAUTI) rates than male patients. After adjustment for comorbidities, there was no overall evidence of higher HAI rates among elderly patients. In patients with acute cardiovascular disease, women had higher rates of HAIs. Among patients with pneumonia, there was no significant difference in the rate of HAIs among most age and sex groups. Among surgical patients, all age and sex groups had a significantly higher adjusted rate of developing at least 1 HAI except females 65 years of age or older. Similar results were seen for the outcome of the occurrence rate of HAIs.

Conclusions.

There was not an overall increased risk of HAIs among older patients hospitalized for acute cardiovascular disease, pneumonia, and major surgery after adjustment for comorbidities. The relationship between sex and the rate of HAIs varied depending upon the underlying acute reason for hospitalization.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue S3: Preventing Healthcare–Associated Infections: Results and Lessons Learned from AHRQ's HAI Program , October 2014 , pp. S3 - S9
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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