Implications of an intensive care unit urgent transfer in terms of clinical and infectious risk

Background and Objectives: Proper functioning of an intensive care unit (ICU) contributes to efficient hospital management, but what happens when the ICU needs urgent transfer? Considering that healthcare-associated infections (HAIs) are one of the most important factors that can negatively impact patient outcomes in an ICU, we retrospectively reviewed cases that occurred in an ICU in our hospital on January 6, 2017. We assessed the cumulative incidence of HAIs in patients admitted to the ICU before and after transfer, and overall impact on the three hospital’s ICUs. Methods: The clinical records of inpatients admitted to the ICU in the 6 months before and after transfer were analyzed to assess the occurrence of HAI. 482 Demographic data were collected to describe the patients. The overall impact on ICU activity was analyzed considering six-month mortality rates for the period 2015-2019. Descriptive statistics and a multivariable model were performed including all parameters that were significantly correlated with HAI occurrence in the univariate analysis. Results: The revision was conducted on 393 clinical records. The number of patients included in the study of the occurrence of at least one HAI was 304, as 89 patients were excluded because their length of stay in the ICU was less than 48 hours. HAIs occurred in 13.1% of patients before and in 6.9% after transfer. Pneumonia accounted for 52.9% of HAIs, bloodstream infections for 29.4%, urinary tract infections for 14.7%. No significant difference in incidence was observed between the two periods. The presence of a central venous catheter was significantly associated with the occurrence of at least one HAI (p=0.045). Conclusions: Urgent transfer of the ICU did not appear to have an impact on clinical and infectious risk, as no difference in infectious disease incidence and mortality was observed likely due to the dedicated work of the healthcare staff.