OBJECTIVE To explore the risk factors for hospital-associated infections (HAI) in dead patients so as to provide bases for development of prevention strategies for the hospital-associated infections.

METHODS Totally 560 patients who died due to non-SARS-CoV-2 infections and hospitalized in Gansu Provincial People′s Hospital for more than 48 hours in 2019 and 2023 were retrospectively analyzed, 70 of whom had HAI and were assigned as the HAI group, and the rest of 490 patients were assigned as the non-HAI group. The incidence of HAI, major causes of death, risk factors and economic burden were observed.

RESULTS The incidence of HAI was 12.50% among the dead patients, the lower respiratory tract infection was the predominant type of infection, and the respiratory failure was the primary and direct cause of death in the HAI group; the total treatment cost of the HAI group was higher than that of the non-HAI group (P < 0.05). Univariate analysis showed that there were significant differences in the length of hospital stay, multidrug-resistant organisms infections, combined use of antibiotics, surgery, hemodialysis/peritoneal dialysis, invasive procedures (drainage, puncture, intubation, tracheotomy), use of equipment like ventilator or urinary catheter, central venous catheter indwelling, blood transfusion, and use of immunosuppressors/glucocorticoids between the HAI group and the non-HAI group(P < 0.05), while there were no significant differences in the sex, age, underlying diseases, modified early warning score (MEWS) and major diagnosis and chemoradiotherapy between the two groups. Multivariate analysis indicated that the length of hospital stay more than 14 days, history of surgery and combined use of antibiotics were the risk factors for HAI in the dead patients (P < 0.05).

CONCLUSION It is necessary for the hospital to identify the high-risk patients as early as possible, pay close attention to the lower respiratory tract infection, reduce the risk of HAI by shortening the length of hospital stay, standardizing the invasive procedures and reasonably using antibiotics so as to improve the prognosis of the patients.