INCIDENCE AND RISK FACTORS OF NOSOCOMIAL INFECTIONS IN ELDERLY AND ADULT PATIENTS IN INTENSIVE CARE UNITS

Introduction: The aim of this study was to investigate the incidence and risk factors for the development of nosocomial infections (NI) in elderly patients who were treated in the medical intensive care units (ICU). Factors affecting mortality were also evaluated. Materials and Method: A total of 433 patients who were treated in the ICU for over 48 hours were included in the study. 228 of the patients were over 65 years of age (elderly group), and 205 were between 18 to 65 years of age (adult group). The elderly and adult groups were compared taking into consideration the risk factors for NI development, causative organisms and mortality rates. Patients in the elderly group with or without NI were also compared. Results: There was no significant difference between the elderly and adult groups regarding the development of NI (p>0.05). In the elderly group with NI, duration of hospitalization and mortality rate were found to be significantly higher (p<0.001). In both groups the most frequently encountered NI was pneumonia, and the utilization of mechanical ventilation (MV) was high. In a multivariate analysis, 65 or higher age, prolonged hospitalization, application of central venous catheters and MV, altered consciousness, presence of chronic systemic diseases, NI and malignancy were independent risk factors contributing to the mortality. Conclusion: Although increased age is not the only factor for development of NI in patients admitted to ICUs, the development of NI, especially pneumonia, is a major cause of mortality in elderly patients.