Background: The effect of age and infection on outcome after trauma is unkn
own. We evaluated the incidence and impact that nosocomial infection (NI) a
nd age have on morbidity and mortality, Several risk factors were identifie
d and analyzed for correlation dth infection.
Methods: Prospective data were collected an patients admitted for greater t
han or equal to 3 days over a 2-year period. Each patient was followed by a
n infectious disease specialist throughout their hospitalization. Centers f
or Disease Control and Prevention guidelines were used to diagnose infectio
n.
Results:Of the 3,254 patients admitted, 88% were < 65 and 12% were <greater
than or equal to> 65 years of age. Injury Severity Store was not significa
ntly different (alder vs. younger), Five hundred one (17.4%) of the younger
patients del eloped an NI with a significantly higher hospital length of s
tay (LOS), intensive care unit (ICU) LOS, and mortality compared with the n
oninfected group. One hundred forty-seven (39%) of the older group develope
d an NI and also had significant increases in hospital LOS, ICU LOS, and mo
rtality: Older infected patients had the highest hospital LOS, ICU LOS, and
mortality, The greatest relative risk of mortality was demonstrated with t
he combination of increased age and NI. Once infected, however, younger pat
ients with penetrating trauma had a greater relative risk of mortality in t
he group-specific comparison. Many risk factors were associated with infect
ion, Only chronic obstructive pulmonary disease in elderly trauma patients
was a significant independent risk factor for infection.
Conclusion: NI significantly increases hospital LOS, ICU LOS, and mortality
after injury, Age increases risk of infection matched for injury severity,
with a significantly higher hospital LOS, ICU LOS, and mortality. Once inf
ected, however, younger patients with penetrating trauma have the greatest
risk of mortality, Chronic obstructive pulmonary disease in elderly trauma
patients was found to he an independent predictor of infection.