Risk factors for incidence and case-fatality rates of healthcare-associated infections: A 20-year follow-up of a hospital-based cohort

R. F. Wang, S. H. Shen, A. M F Yen, T. L. Wang, T. N. Jang, S. H. Lee, J. T. Wang, H. H. Chen

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Information is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0 46 to 0 32 deaths/1000 patient-days and the incidence rate fell from 3 41 to 2 31/1000 patient-days, but the case-fatality rate increased marginally from 13 5% to 14 0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.

Original languageEnglish
Pages (from-to)198-206
Number of pages9
JournalEpidemiology and Infection
Issue number1
Publication statusPublished - Jan 1 2016



  • Case-fatality
  • healthcare-associated infection
  • incidence
  • incidence-death cohort

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)
  • Infectious Diseases

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