Meta analysis on risk factors for healthcareassociated infection in patients with acute myocardial infarction

Abstract:

ObjectiveTo systematically evaluate risk factors for healthcareassociated infection(HAI) in patients with acute myocardial infarction（AMI）. MethodsLiteratures about risk factors for HAI in AMI patients were retrieved from PubMed, EMbase, the Cochrane Library, China Biological Medicine Disk (CBM), WanFang Data, China National Knowledge Infrastructure (CNKI), and VIP Database from the establishment of database to December 2017, two independent researchers screened literatures, extracted data, and evaluated quality according to inclusion and exclusion criteria, then performed Meta analysis using RevMan 5.3 software.ResultsThere are 12 literatures in accordance with the inclusion criteria, with a total sample size of 13 812 cases. According to Meta analysis, 12 risk factors were statistically significant (all P<0.05): age (OR, 3.45 ［95%CI, 1.02-7.95］), length of hospital stay(OR, 4.84 ［95% CI， 2.47-7.14］), tracheal intubation (OR, 7.74 ［95% CI, 3.73-9.02］), preventive use of antimicrobial agents (OR, 6.79 ［95% CI, 2.38-9.45］), mechanical ventilation (OR, 2.98 ［95% CI，1.05-4.78］), urinary catheterization (OR, 3.56 ［95% CI, 1.24-4.49］), heart failure(OR，3.82 ［95% CI, 2.53-5.74］), arrhythmia (OR, 2.47 ［95%CI,  1.28-4.63］), diabetes (OR， 2.23 ［95% CI, 1.62-3.27］), chronic obstructive pulmonary disease (OR， 2.14 ［95% CI, 1.83-3.91］), use of H2 blockers (OR, 2.61 ［95% CI, 1.87-4.36］), and left ventricular ejection fraction<30% (OR, 2.98 ［95% CI, 1.35-4.26］). The publication bias of each risk factor was analyzed, and the results showed that publication bias was not obvious.ConclusionHealth care workers should timely identify the highrisk population for HAI, strictly adhere to indications of invasive procedure, standardize the disinfection and isolation system, strengthen the process management of aseptic technique, and actively take preventive measures to reduce risk for HAI in AMI patients.