Influence of nosocomial infections on activities of daily living in acute geriatric inpatients

Abstract

Nursing home residents and older hospitalized patients have asignificantly higher risk to suffer from nosocomial infections (NI). It is still an unanswered question whether patients suffering from NI are at greater risk for deterioration of activities of daily living. In aretrospective observational study, we evaluated the prevalence of NI during hospitalization of acute geriatric inpatients of the geriatric department at Jena University Hospital by patient records. The study included data from 555 patients, hospitalized from 1August 2011 to 31August 2012. We included patients without acute complications and those who developed NI after the second day of hospitalization. Every third patient developed aNI during the observation period. Consequently, the incidence of NI was approximately 18patients with NI per 1000 days of hospitalization. This rate was considerably higher than the national average. The most frequent NIs were urinary tract infection, gastroenteritis and infections of the lower respiratory tract. Alow value of Barthel index at admission, high multimorbidity index and transurethral indwelling catheters promoted the development of NI. An improvement in activities of daily living, assessed by mean values of the difference in the Barthel index, was significantly lower in patients who developed NI (mean value14.5± 16.3) than in patients who did not (mean value 18.1± 14.8). Nosocomial infections were arelevant factor for deterioration of the Barthel Index, at least temporarily and NIs, in particular the combination of several NIs, jeopardized an improvement in the activities of daily living. This was particularly true for infections of the lower respiratory tract and gastroenteritis.