Fatores de risco associados às infecções relacionadas à assistência à saúde em Unidades de Terapia Intensiva Adulto: revisão de escopo

Abstract

Nosocomial Infection (NI) are recognized by the World Health Organization as a problem of broad global magnitude. HAIs are a serious public health problem, they can be caused by several risk factors, which vary according to the hospital context, patient profile and health care practices adopted, and can thus assess that carrying out a systematic review to identify risk factors for HAIs will become a useful tool for infection control. Identify and map the risk factors associated with healthcare-associated infections in people hospitalized in adult intensive care units. This is a scoping review developed within the recommendations of the Joanna Briggs Institute and PRISMA-SCR (DOI 10.17605/OSF.IO/MYEJ5), developed in five stages: 1) identification of the research question; 2) identification of relevant studies; 3) selection of studies; 4) data extraction, separation, summarization and reporting of results and 5) communication of results. According to JBI, the Participant, Concept and Context mnemonic was applied to construct the research question, in which Participant corresponds to “People in hospital”, Concept “Risk factors for healthcare-related infections” and the Context “Adult ICU”, and the guiding question was: “What are the risk factors in the development of HAIs in people admitted to intensive care units?”. The search was carried out in eleven databases. 6989 studies were found, including 109 of them. Fifty-nine variables were obtained that can be evaluated as predictive factors for NI, namely: age (40.3%), sex (44%), smoking (4.5%) and alcohol consumption (2.7%). Cancer (6.4%), Diabetes Mellitus (DM) (12.84%), Chronic obstructive disease (COPD) (8.25%), Kidney diseases (9.17%), Ischemic heart disease (2.75 %), Systemic Arterial Hypertension (SAH) (4.58%), Human Immunodeficiency Virus – Acquired Immunodeficiency Syndrome (HIV-AIDS) (1.83%), Previous infections (4.58%), Liver Failure (1 .83%), and obesity (4.58%). Antibiotics (14.6%), Corticosteroids (2.75%) and Immunosuppressive therapy (4.5%). Respiratory syndromes (4.58%), trauma (13.76%). Coma (11%), sedation (6.42%). APACHE (2%), SAPS (4.58%). Nutrition: enteral (6.42%), parenteral (8.25%), malnutrition (1.3%). Intubation (12.84%), reintubation (4.58%), tracheostomy (16.51%), performing some procedure (1.83%). Antacids (4.58%), antibiotic therapy (4.5%), vasoactive drugs (1.83%), hemotherapy (3.66%). Night admission (0.91%), team sizing (2.75%); length of stay in the ICU (33%), type of hospitalization (in ICU) (3.66%), aseptic techniques (2.75%) and out-of-hospital transport (0.91%). Central Venous Catheter (11%) and time of use (7.3%), Peripheral Venous Catheter (1.8%), urinary catheter (15.59%) and time of use (4.58%), drain (1.83%), endotracheal tube (11%), mechanical ventilator (33%) and time of use (13.7%). CD4 (1.83%), hypoalbuminemia (0.91%), leukocytosis (0.91%), neutropenia (2.75%). Bronchoscopy (1.83%) and cystoscopy (0.91%). The development of this study culminated in mapping the patient's sociodemographic risk situation for the development of HAIs, in addition to the medical conditions upon admission, and care during hospitalization that may influence the increased risk of developing these infections.