Relationship between death and infections among patients hospitalized in internal medicine departments: A prevalence and validation study

• Published in: American journal of infection control Vol. 42; no. 5; pp. 506 - 510
• Main Authors: Boisen, Anne B., MB, Dalager-Pedersen, Michael, MD, Søgaard, Mette, DVM, PhD, Mortensen, Rikke, MSc, Thomsen, Reimar W., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-05-2014; Elsevier; Mosby-Year Book, Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Infections - epidemiology; Bacterial Infections - mortality; Bacterial infections and mycoses; Biological and medical sciences; Cause of death/vital statistics; Confidence intervals; Cross Infection - epidemiology; Cross Infection - mortality; Death & dying; Denmark - epidemiology; Epidemiology; Epidemiology. Vaccinations; Female; General aspects; Hospital Departments; Hospitalization; Hospitals, University; Humans; Infection Control; Infections; Infectious Disease; Infectious disease medicine; Infectious diseases; Internal Medicine; Male; Medical sciences; Middle Aged; Mycoses - epidemiology; Mycoses - mortality; Prevalence; Prospective Studies; Validation studies; Young Adult; Denmark; Bacterial infections and mycoses; Infectious disease medicine; Cause of death/vital statistics; Epidemiology; Human; Prognosis; Prevalence; Mycosis; Mortality; Check; Hospitalization; Infection; Prevention; Bacteriosis; General practice
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2013.12.011

Background We assessed the burden of infection-related death at internal medicine departments in Denmark and the validity of 2 population-based registries for diagnoses of infection. Methods We reviewed medical records of all inpatients who died at a large university hospital during 2008 with an infection diagnosis in the Cause of Death Registry (CDR) or Hospital Discharge Registry (HDR). We computed the positive predictive value of infection diagnoses and completeness of each registry with 95% confidence intervals (CIs) and the prevalence of infection-related deaths by capture-recapture analysis. Results Among 458 deaths, 193 patients (42.1%) had an infection diagnosis of which 40.0% (183 out of 458) were verified. The positive predictive value of an infection diagnosis was 96.0% (95% CI, 92.0%-98.3%) in the CDR and 95.3% (CI, 90.9%-97.9%) in the HDR. Completeness of the CDR was 79.2% (CI, 72.9%-84.6%) and completeness of the HDR was 77.0% (CI, 70.6%-82.7%). By capture–recapture analysis we estimated that 43.2% of all deaths (198 out of 458) were related to infection. Conclusions The large proportion of deaths in internal medicine departments that are related to infection emphasizes the need for optimized infection prevention and treatment strategies. CDR and HDR are valid sources for identifying infection and may supplement each other for increased completeness of infection-related death in epidemiologic research.