J Korean Biol Nurs Sci.  2020 Nov;22(4):249-259. 10.7586/jkbns.2020.22.4.249.

Survival Factors among Medical Intensive Care Unit Patients with Carbapenemas-Producing Enterobacteriaceae

• Choi JE
• Jeon MY

• KMID: 2509057
• DOI: http://doi.org/10.7586/jkbns.2020.22.4.249

Abstract

Purpose
Carbapenemase-producing Enterobacteriaceae (CPE) are associated with considerable mortality. This study was aimed to identify survival factors among medical care unit patients with CPE.
Methods
We conducted a retrospective cohort; data were collected from September 2017 to June 2019 through electronic medical records. The data collected were general characteristics, disease-related characteristics, severity-related characteristics, and treatment-related characteristics. Data were analyzed based on frequency, mean, standard deviation, Chi-square test, Fisher’s exact test, t-test, Pearson’s correlation coefficient, and Cox proportional hazard model using SPSS/WIN 21.0 program.
Results
Seventy-seven patients were included (59 survivors and 18 deceased) in the study. Univariate analysis identified factors for survival associated with acquired CPE as age (t= -1.56, p= .037), simplified acute physiology 3 (SAPS3) score of admission date (t= -2.85, p= .006), Glasgow coma scale (GCS) of CPE acquisition date (t= 2.38, p= .020), artery catheter at CPE acquisition date (χ² = 4.58, p= .032), vasoconstrictor agents use at CPE acquisition date (χ² = 6.81, p= .009), platelet at CPE acquisition date (t= 2.27, p= .025), lymphocyte at CPE acquisition date (t= 2.01, p= .048), calcium at CPE acquisition date (t= 2.68, p= .009), albumin at CPE acquisition date (t= 2.29,p= .025), and creatinine at CPE acquisition date (t= 2.24, p= .028). Multivariate Cox proportional hazard model showed that GCS at CPE acquisition date (HR= 1.14, 95% CI= 1.05-1.22), lymphocyte at CPE acquisition date (HR= 1.05, 95% CI= 1.00-1.10), and creatinine at CPE acquisition date (HR= 1.25, 95% CI= 1.04-1.49) were independent survival factors among medical intensive care unit patients with CPE.
Conclusion
Based on the study results, it is necessary to develop nursing interventions that can aid in the management of patients with CPE and identify their effects.

Keyword

Carbapenemase; Enterobacteriaceae; Enterobacteriaceae; Intensive care units; Intensive care units; Survival; Survival