Healthcare-Associated Infections Impact Mortality in Patients Admitted to Acute Care Hospital from Emergency Department

Background/Objectives: Prolonged stays in the emergency department (ED) may contribute to an increase in the rate of healthcare-associated infections (HAIs) with an increased risk of mortality. Early identification of the risk profile of these patients could reduce both complications and adverse outcomes. The study aimed to verify whether the development of an HAI was associated with mortality. Design, settings and participants: This prospective multicentre study involved all subjects, who required urgent admission to an acute care hospital from the ED, between 2023 and 2024. Outcome measures: The primary endpoint was 30-day mortality. A Cox proportional hazards model was used to test the hypothesis. Results: Of the 27,516 patients included in the analysis, with a mean age of 79 [20] years (median [IQR]), 1,575 (7.8%) died. The main features, in order of importance, selected for predicting mortality were: diagnosis of neoplasm; older age; NEWS; diagnosis of infectious diseases; HAIs; diagnosis of respiratory diseases; CCI; priority level on arrival; and male gender, yielding an accuracy of 0.804 ± 0.012. The development of a nosocomial infection was associated with a mortality risk ratio of 1.518 (95% confidence interval (CI): 1.338–1.721; p < 0.001), particularly high for bloodstream infections (2.54; 2.12–3.06) and pneumonia (1.44; 1.20–1.73). Conclusion: In patients admitted to acute care hospital from the ED, the development of HAIs is associated with an increased risk of mortality. This risk is particularly elevated in cases of bloodstream infections and pneumonia.