English summary: BURDEN OF HEALTH CARE-ASSOCIATED INFECTIONS (HAIS) IN FINNISH ACUTECARE HOSPITALS

Background

No data on morbidity and mortality related to HAIs in Finland exists. We made an estimation based on the first national prevalence survey for HAIs performed in 2005 in Finland. We also evaluated the completeness of the National Hospital Discharge Registry (HILMO) as a source of data on HAIs.

Methods

The prevalence survey included all adult inpatients (n=8234) in 30 acute care hospitals. A total of 753 HAIs were recorded in 703 (8.5%) patients. Using the date of the prevalence survey and the patient's national identity code, data on hospitalizations including ICD-10 codes for discharge diagnoses were obtained from the HILMO and the dates and causes of death from the National Population Information System. The incidence of HAIs was calculated by the Rhame and Sudderth formula. Using the incidence of HAIs and the 28-day case fatality of HAI patients, the annual estimates were extrapolated from the total number of hospitalizations in Finnish acute care hospitals in 2005 (n=804,456).

Results

We estimated that annually 48,000 hospitalizations lead to at least one HAI and that 1,500 patients die with an HAI. In 34% of patients with HAIs, the ICD-10 codes in the HILMO indicated an infection. The proportion was highest in the case of severe infections, e.g. 54% in the case of surgical site/organ space infections.

Conclusions

Our disease burden estimates could be used for resource allocation. The sensitivity of discharge diagnoses for recognizing HAIs was low, but they should not be overlooked as an additional case finding method, especially for severe HAIs.