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Long-term outcomes from nosocomial infections in persons with spinal cord injuries and disorders.

Lavela SL, Evans CT, Miskevics S, Parada JP, Priebe M, Weaver FM. Long-term outcomes from nosocomial infections in persons with spinal cord injuries and disorders. American journal of infection control. 2007 Aug 1; 35(6):393-400.

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BACKGROUND: Nosocomial infection may contribute to poor long-term consequences in persons who have spinal cord injuries and disorders (SCIandD). METHODS: This is a cohort study of individuals who had SCIandD and were hospitalized at least once during 2002. They were followed for 3 years to assess inpatient (IP) admissions, total IP length of stay (LOS), outpatient (OP) visits, and mortality. Count data models and a Cox proportional hazards model were used to assess the relationship between previous infection and subsequent IP and OP use and long-term mortality, respectively. RESULTS: Of persons who had SCIandD, 59% had at least one nosocomial infection. Multivariable regression indicated that veterans who had SCIandD had more IP admissions (b = 0.405; P < .0001) and longer IP LOS (b = 0.843; P < .0001) if they had a previous infection; however, infection status was not a predictor of future OP visits. Survival time was lower (913.93 versus 1034.75 days, P = .004) in the infection group. Death rate was higher in the nosocomial infection group (30.11% versus 10.77%; P = .004), but the association did not achieve significance in the Cox proportional hazards model (P = .12). CONCLUSIONS: Nosocomial infections have serious subsequent consequences that result in future hospitalization and shorter survival. Efforts to prevent nosocomial infections are needed to reduce long-term adverse effects in persons who have SCIandD.

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