Healthcare-Associated Infections in Patients with Multiple Trauma: Risk Factors and Mortality

Akçimen S., İnan D., Yılmaz M., Koyuncu Özyurt Ö., Akçimen M.

Black Sea Journal of Health Science, cilt.9, sa.2, ss.48-54, 2026 (Hakemli Dergi)

Özet

Abstract: This prospective cohort study aimed to determine the incidence of healthcare-associated infections in multiple trauma patients admitted to the intensive care unit, to identify independent risk factors associated with these infections, and to evaluate their impact on mortality. The study included 137 multiple trauma patients over the age of 18 who were admitted to the Anesthesiology Intensive Care Units of Akdeniz University Hospital between November 01, 2013, and October 31, 2014, and remained in the Intensive Care Units for at least 48 hours. Data were collected prospectively, including demographic characteristics, type of trauma, Glasgow Coma Scale score, invasive procedures, and clinical outcomes. The incidence of healthcare-associated infections was found to be 29.2%, with ventilator-associated pneumonia being the most common type of infection (52%). In univariate analysis, combined enteral and parenteral nutrition (P<0.001), a Glasgow Coma Scale score ≤8 (P=0.014), and intensive care unit stay longer than 10 days (P<0.001) were identified as significant risk factors for the development of healthcare-associated infections. Multivariate analysis revealed that an intensive care unit stay longer than 10 days increased the risk of healthcare-associated infections by 25.62 times, and a Glasgow Coma Scale score ≤8 increased the risk by 3.24 times. Patients who developed infections had a 2.89-fold higher risk of mortality compared with those without infections (P=0.013). The findings suggest that interventions targeting modifiable risk factors are critically important in reducing nosocomial infections. Future multicenter, prospective studies are recommended to validate these results.