Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-26T04:52:50.748Z Has data issue: false hasContentIssue false
  • English
  • Français

Behavior of Cross-Sectional Surveys in the Hospital Setting: A Simulation Model

Published online by Cambridge University Press:  21 June 2016

Jose Rossello-Urgell  and
Alicia Rodriguez-Pla
Jose Rossello-Urgell*
Affiliation:
Hospital Universitario Valle de Hebron, Barcelona, Spain
Alicia Rodriguez-Pla
Affiliation:
Johns Hopkins Hospital, Baltimore, Maryland
*
Servicio de Medicina Preventiva y Epidemiologia, Hospital Universitario Vall d'Hebron, p Vall d'Hebron 119-129, 08035 Barcelona, Spainjrossello@vhebron.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To date, it has not been adequately proven whether the published formulas used to obtain incidence from the prevalence of nosocomial infections provide a good estimate of real incidence. With the hypothesis that within the hospital setting prevalence may be lower than incidence, the aim of this study was to analyze the behavior of point prevalence as it relates to cumulative incidence and duration of infection.

Design:

Hospital simulation study.

Methods:

By randomly selecting a sample of infected patients within a specific range of cumulative incidences and infection durations, we constructed a simulated hospital population, allowing us to estimate daily point prevalences and their maximum and minimum values. The association between the different components of stay and cumulative incidence was evaluated to obtain a more accurate estimate of incidence.

Results:

Prevalence can be lower than, equal to, or higher than the corresponding incidence. For all incidence levels, prevalence was increasing with duration. Between 14 and 20 days of infection duration, prevalence was consistently lower than incidence. Prevalence duration of infection was approximately half the time of the total duration.

Conclusions:

The existing formulas relating incidence and prevalence can frequently be inadequate. Until a validated system for converting prevalence into incidence is available, we do not believe their use is appropriate.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 4 , April 2005 , pp. 362 - 368
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Sohn, AH, Garrett, DO, Sinkowitz-Cochran, RL, et al.Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr 2001;139:821–827.Google Scholar
2.Gastmeier, P, Kampf, G, Wischnewsky, N, et al.Prevalence of nosocomial infections in representative German hospitals. J Hosp Infect 1998;38:37–49.Google Scholar
3.Vaqué, J, Rosselló, J, Arribas, JL, EPINE Working Group. Prevalence of nosocomial infections in Spain: EPINE study 1990-1997. J Hosp Infect 1999;43(suppl):105–111.CrossRefGoogle ScholarPubMed
4.Gaynes, RP, Horan, TC. Surveillance of nosocomial infections. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control, ed. 3. Philadelphia: Lippincott Williams and Wilkins; 1999:1285–1318.Google Scholar
5.French, GL, Wong, SL, Cheng, ABF, Donnan, S. Repeated prevalence surveys for monitoring effectiveness of hospital infection control. Lancet 1989;334:1021–1023.Google Scholar
6.Christensen, M, Jepsen, OB. Reduced rates of hospital-acquired UTI in medical patients: prevalence surveys indicate effect of active infection control programmes. J Hosp Infect 2001;47:36–40.Google Scholar
7.Freeman, J, Hutchinson, GB. Prevalence, incidence and duration. Am J Epidemiol 1980;112:707–723.Google Scholar
8.Freeman, J, McGowan, JE Jr.Day-specific incidence of nosocomial infection estimated from a prevalence survey. Am J Epidemiol 1981;114:888–901.Google Scholar
9.Rhame, FS, Sudderth, WD. Incidence and prevalence as used in the analysis of the occurrence of nosocomial infections. Am J Epidemiol 1981;113:1–11.CrossRefGoogle ScholarPubMed
10.Delgado-Rodríguez, M, Cueto Espinar, A, Rodríguez-Contreras Pelayo, R, Gálvez Vargas, RA. Practical application of Rhame and Sudderth's formula on nosocomial infection surveillance. Rev Epidemiol Sante Publique 1987;35:482–487.Google Scholar
11.Gastmeier, P, Brauer, H, Sohr, D, et al.Converting incidence and prevalence data of nosocomial infections: results from eight hospitals. Infect Control Hosp Epidemiol 2001;22:31–34.CrossRefGoogle ScholarPubMed
12.Graves, N, Nicholls, TM, Wong, CGS, Morris, AJ. The prevalence and estimates of the cumulative incidence of hospital-acquired infections among patients admitted to Auckland District Health Board hospitals in New Zealand. Infect Control Hosp Epidemiol 2003;24:56–61.CrossRefGoogle ScholarPubMed
13.Haley, RW. Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med 1981;70:51–58.CrossRefGoogle ScholarPubMed
14.Rosenthal, VD, Guzman, S, Orellano, PW. Nosocomial infections in medical-surgical intensive care units in Argentina: attributable mortality and length of stay. Am J Infect Control 2003;31:291–295.CrossRefGoogle ScholarPubMed
15.Song, X, Srinivasan, A, Plaut, D, Perl, TM. Effect of nosocomial vancomycin-resistant enterococcal bacteremia on mortality, length of stay, and costs. Infect Control Hosp Epidemiol 2003;24:251–256.CrossRefGoogle ScholarPubMed
16.Mahieu, LM, Buitenweg, N, Beutels, P, De Dooy, JJ. Additional hospital stay and charges due to hospital-acquired infections in a neonatal intensive care unit. J Hosp Infect 2001;47:223–229.Google Scholar
17.Delgado-Rodríguez, M, Medina-Cuadros, M, Bueno-Cavanillas, A, Martinez-Gallego, G, Dierssen, T, Sillero-Arenas, M. Comparison of two procedures to estimate the hospital stay attributable to nosocomial infection: matched cohort study versus analysis of covariance of the total unmatched cohort. J Clin Epidemiol 1997;50:773–778.CrossRefGoogle ScholarPubMed
18.Schulgen, G, Kropec, A, Kappstein, I, Daschner, F, Schumacher, M. Estimation of extra hospital stay attributable to nosocomial infections: heterogeneity and timing of events. J Clin Epidemiol 2000;53:409–417.Google Scholar