Risk factors for Healthcare-associated Infection on a Rehabilitation Unit

Objective: Ascertain healthcare-associated infection (HAI) prevalence and identify risk factors associated with a higher incidence of infection in a Rehabilitation Ward. Materials and Methods: Two-year retrospective cohort study conducted in a post-acute Rehabilitation Ward of a tertiary-care, public, university-affiliated hospital. Demographic and clinical data were collected from electronic medical record. The assessment of risk factors was done by comparison of patients with or without HAI. Univariate and multivariate logistic regression analysis was used to identify risk factors. Results: There were 262 admissions to the Rehabilitation Ward during the study period. One-hundred thirty-one HAIs were detected in 95 (36.3%) of the 262 patients. The most common infections were urinary tract infections (87.8% of all infections). An age-sex adjusted multivariate logistic regression model showed that urinary catheter, surgery in the last 30 days and length of stay >= 30 days were independent risk factors for HAI. Length of stay was associated with an increased odd of developing HAI (median length of 28 days for those without HAI, 35 days for those with only one HAI and 55 days for patients having >= 2 HAI). Only one patient died of infection. Conclusions: HAI is a frequent complication in a post-acute Rehabilitation Ward. The logistic regression model identified patients with urinary catheter, surgery in the last 30 days and length of stay >= 30 days as having an higher risk for HAI, thereby being the main targets of surveillance and adoption of preventive measures.