Developing a Registry of Healthcare-Associated Infections at Intensive Care Units in West China: Study Rationale and Patient Characteristics

Abstract

Wen Wang,1,* Shichao Zhu,2,* Qiao He,1 Rui Zhang,3 Yan Kang,4 Mingqi Wang,1 Kang Zou,1 Zhiyong Zong,2,5,* Xin Sun1,* 1Chinese Evidence-Based Medicine Center and CREAT Group, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 2Department of Infection Control, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 3Information Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 4Intensive Care Unit, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 5Center of Infection Diseases, West China Hospital of Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xin SunChinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, People’s Republic of ChinaEmail [email protected] ZongDepartment of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaEmail [email protected]: Limited evidence is available to support the management of healthcare-associated infections (HAIs) in intensive care units (ICUs). Establishing a registry with complete and accurate information is urgently needed. The West China Hospital system has the most complete and largest data system for HAI in the ICU setting in China. By linking a multidimensional database, we developed a registry of HAI in ICU.Methods: The ICU-HAI registry was established using a multi-source database that included electronic medical record (EMR), ICU system and ICU-HAI system in the West China Hospital healthcare system. Patients who were admitted to ICUs between 1 April 2015 and 30 March 2018 were included and data were extracted based on pre-designed, standardized data forms. We achieved the linkage of the three databases using a unique patient identification code, and cleaned the data based on standardized variable dictionaries and cleaning rules. We evaluated the quality of the registry through data verification and assessment of the quality of key variables.Results: In total, 23, 062 patients were included. The ICU mortality and hospital mortality were 5.4% and 5.5% respectively. A total of 855 patients developed ICU-HAIs, 1540 patients developed ventilator-associated events (VAE), and 171 patients developed possible ventilator-associated pneumonia (PVAP). Quality assessment showed that the accuracy of data extraction and linkage was 100%. Furthermore, 98% of all patients had at least one important laboratory tests performed, and the median number of tests performed was 4 to 5 per admission.Conclusion: A unique registry for HAIs in the ICU setting was successfully established, which contains complete and accurate information for all patients in the ICU. The registry, linked from multiple data sources, provides unique research insights into the management of HAIs in the ICU setting in China.Keywords: healthcare-associated infection, intensive care units, registry  

Keywords

• healthcare-associated infection
• intensive care units
• registry