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Original Articles
Factors associated with in-hospital death in patients with nosocomial infections: a registry-based study using community data in western Iran
Salman Khazaei, Erfan Ayubi, Ensiyeh Jenabi, Saeid Bashirian, Masud Shojaeian, Leili Tapak
Epidemiol Health. 2020;42:e2020037.   Published online June 1, 2020
DOI: https://doi.org/10.4178/epih.e2020037
  • 13,374 View
  • 265 Download
  • 2 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
Objectives
Determining the predictors of in-hospital death related to nosocomial infections is an essential part of efforts made in the overall health system to improve the delivery of health care to patients. Therefore, this study investigated the predictors of in-hospital death related to nosocomial infections.
Methods
This registry-based, longitudinal study analyzed data on 8,895 hospital-acquired infections (HAIs) in Hamadan Province, Iran from March 2017 to December 2019. The medical records of all patients who had been admitted to the hospitals were extracted from the Iranian Nosocomial Infections Surveillance Software. The effects of the type and site of infection, as well as age group, on in-hospital death were estimated using univariate and multivariable Cox regression models.
Results
In total, 4,232 (47.8%) patients with HAIs were males, and their mean age was 48.25±26.22 years. In both sexes, most nosocomial infections involved Gram-negative bacteria and the most common site of infection was the urinary tract. Older patients had a higher risk of in-hospital death (adjusted hazard ratio [aHR], 2.26; 95% confidence interval [CI], 1.38 to 3.69 for males; aHR, 2.44; 95% CI, 1.29 to 4.62 for females). In both sexes, compared with urinary tract infections, an increased risk of in-hospital death was found for ventilator-associated events (VAEs) (by 95% for males and 93% for females) and bloodstream infections (BSIs) (by 67% for males and 82% for females).
Conclusion
We found that VAEs, BSIs, and fungal infections were independently and strongly associated with increased mortality.
Summary

Citations

Citations to this article as recorded by  
  • Predictors of In-ICU Mortality Among Older Patients with Healthcare-Associated Infection: A Cohort Study
    Fereshteh Rezaie, Farahnaz Mohammadi-Shahboulaghi, Reza Fadayevatan, Mohsen Shati, Gholamreza Ghaedamini Harouni
    Journal of Kermanshah University of Medical Sciences.2023;[Epub]     CrossRef
  • Barriers to hand hygiene compliance in intensive care units to prevent the spread of healthcare-associated infections
    Gurjeet Singh, Raksha Singh, Ranga Reddy Burri
    MGM Journal of Medical Sciences.2023; 10(4): 667.     CrossRef
  • Prevalence of Nosocomial Infections During the COVID-19 Pandemic: A Systematic Review and Meta-analysis
    Sima Rafiei, Zahra Nejatifar, Rana Soheylirad, Samira Raoofi, Fatemeh Pashazadeh Kan, Ahmad Ghashghaee
    Journal of Health Reports and Technology.2022;[Epub]     CrossRef
  • Prevalence of Nosocomial Infections During the COVID-19 Pandemic: A Systematic Review and Meta-analysis
    Sima Rafiei, Zahra Nejatifar, Rana Soheylirad, Samira Raoofi, Fatemeh Pashazadeh Kan, Ahmad Ghashghaee
    Journal of Health Reports and Technology.2022;[Epub]     CrossRef
  • The Impact of COVID-19 Outbreak on Nosocomial Infection Rate: A Case of Iran
    Maryam Jabarpour, Mahlagha Dehghan, Giti Afsharipour, Elham Hajipour Abaee, Parvin Mangolian Shahrbabaki, Mehdi Ahmadinejad, Mahboobeh Maazallahi, Aseer Manilal
    Canadian Journal of Infectious Diseases and Medical Microbiology.2021; 2021: 1.     CrossRef
  • Survival rate in patients with ICU-acquired infections and its related factors in Iran’s hospitals
    MEDSKorosh Etemad, Yousef Khani, Seyed-Saeed Hashemi-Nazari, Neda Izadi, Babak Eshrati, Yadollah Mehrabi
    BMC Public Health.2021;[Epub]     CrossRef
Spatial modeling of cutaneous leishmaniasis in Iranian army units during 2014-2017 using a hierarchical Bayesian method and the spatial scan statistic
Erfan Ayubi, Mohammad Barati, Arasb Dabbagh Moghaddam, Ali Reza Khoshdel
Epidemiol Health. 2018;40:e2018032.   Published online July 13, 2018
DOI: https://doi.org/10.4178/epih.e2018032
  • 12,932 View
  • 262 Download
  • 5 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to map the incidence of cutaneous leishmaniasis (CL) in Iranian army units (IAUs) and to identify possible spatial clusters.
METHODS
This ecological study investigated incident cases of CL between 2014 and 2017. CL data were extracted from the CL registry maintained by the deputy of health of AJA University of Medical Sciences. The standardized incidence ratio (SIR) of CL was computed with a Besag, York, and Mollié model. The purely spatial scan statistic was employed to detect the most likely highand low-rate clusters and to obtain the observed-to-expected (O/E) ratio for each detected cluster. The statistical significance of the clusters was assessed using the log likelihood ratio (LLR) test and Monte Carlo hypothesis testing.
RESULTS
A total of 1,144 new CL cases occurred in IAUs from 2014 to 2017, with an incidence rate of 260 per 100,000. Isfahan and Khuzestan Provinces were found to have more CL cases than expected in all studied years (SIR>1), while Kermanshah, Kerman, and Fars Provinces were observed to have been high-risk areas in only some years of the study period. The most significant CL cluster was in Kermanshah Province (O/E, 67.88; LLR, 1,200.62; p<0.001), followed by clusters in Isfahan Province (O/E, 6.02; LLR, 513.24; p<0.001) and Khuzestan Province (O/E, 2.35; LLR, 73.71; p<0.001), while low-rate clusters were located in the northeast areas, including Razavi Khorasan, North Khorasan, Semnan, and Golestan Provinces (O/E, 0.03; LLR, 95.11; p<0.001).
CONCLUSIONS
This study identified high-risk areas for CL. These findings have public health implications and should be considered when planning control interventions among IAUs.
Summary

Citations

Citations to this article as recorded by  
  • High-risk spatiotemporal patterns of cutaneous leishmaniasis: a nationwide study in Iran from 2011 to 2020
    Neda Firouraghi, Robert Bergquist, Munazza Fatima, Alireza Mohammadi, Davidson H. Hamer, Mohammad Reza Shirzadi, Behzad Kiani
    Infectious Diseases of Poverty.2023;[Epub]     CrossRef
  • Spatio-temporal visualisation of cutaneous leishmaniasis in an endemic, urban area in Iran
    Neda Firouraghi, Alireza Mohammadi, Davidson H Hamer, Robert Bergquist, Sayyed Mostafa Mostafavi, Ali Shamsoddini, Amene Raouf-Rahmati, Mahmoud Fakhar, Elham Moghaddas, Behzad Kiani
    Acta Tropica.2022; 225: 106181.     CrossRef
  • Spatial patterning of occupational stress and its related factors in Iranian critical care nurses using a hierarchical Bayesian technique
    Morteza Kazemi, Kiavash Hushmandi, Amir Vahedian-Azimi, Majid Moayyed, Leila Karimi, Mohammad Ali Sheikh Beig Goharrizi, Mahmood Salesi, Karim Parastouei, Mehdi Raei
    Work.2022; 72(4): 1409.     CrossRef
  • Socio-Economic Characteristics of Urban Tuberculosis Areas in Petaling, Selangor: A Current Spatial Exploratory Scenario
    N.N.N Mohd Zaini, A.R. Abdul Rasam, C.B. Ahmad
    IOP Conference Series: Earth and Environmental Science.2022; 1067(1): 012041.     CrossRef
  • Cutaneous leishmaniasis based on climate regions in Iran (1998-2021): A systematic review and meta-analysis
    Mehri Rejali, Nadia Mohammadi Dashtaki, Afshin Ebrahimi, Asieh Heidari, MohammadReza Maracy
    Advanced Biomedical Research.2022; 11(1): 120.     CrossRef
  • Molecular Study of Cutaneous Leishmaniasis Species among Soldiers with Dermal Ulcers in Zahedan, Iran
    Sina Sekandarpour, Minoo Shaddel, Zahra Sadat Asadi
    Military Caring Sciences.2021; 7(4): 310.     CrossRef
  • Sensitivity of disease cluster detection to spatial scales: an analysis with the spatial scan statistic method
    Meifang Li, Xun Shi, Xia Li, Wenjun Ma, Jianfeng He, Tao Liu
    International Journal of Geographical Information Science.2019; 33(11): 2125.     CrossRef
Exploring neighborhood inequality in female breast cancer incidence in Tehran using Bayesian spatial models and a spatial scan statistic
Erfan Ayubi, Mohammad Ali Mansournia, Ali Ghanbari Motlagh, Alireza Mosavi-Jarrahi, Ali Hosseini, Kamran Yazdani
Epidemiol Health. 2017;39:e2017021.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017021
  • 15,075 View
  • 227 Download
  • 11 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to explore the spatial pattern of female breast cancer (BC) incidence at the neighborhood level in Tehran, Iran.
METHODS
The present study included all registered incident cases of female BC from March 2008 to March 2011. The raw standardized incidence ratio (SIR) of BC for each neighborhood was estimated by comparing observed cases relative to expected cases. The estimated raw SIRs were smoothed by a Besag, York, and Mollie spatial model and the spatial empirical Bayesian method. The purely spatial scan statistic was used to identify spatial clusters.
RESULTS
There were 4,175 incident BC cases in the study area from 2008 to 2011, of which 3,080 were successfully geocoded to the neighborhood level. Higher than expected rates of BC were found in neighborhoods located in northern and central Tehran, whereas lower rates appeared in southern areas. The most likely cluster of higher than expected BC incidence involved neighborhoods in districts 3 and 6, with an observed-to-expected ratio of 3.92 (p<0.001), whereas the most likely cluster of lower than expected rates involved neighborhoods in districts 17, 18, and 19, with an observed-to-expected ratio of 0.05 (p<0.001).
CONCLUSIONS
Neighborhood-level inequality in the incidence of BC exists in Tehran. These findings can serve as a basis for resource allocation and preventive strategies in at-risk areas.
Summary

Citations

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    Revista Brasileira de Epidemiologia.2023;[Epub]     CrossRef
  • Intra-urban spatial variability of breast and cervical cancer mortality in the city of São Paulo: analysis of associated factors
    Breno Souza de Aguiar, Alessandra Cristina Guedes Pellini, Elizabeth Angélica Salinas Rebolledo, Adeylson Guimarães Ribeiro, Carmen Simone Grilo Diniz, Patricia Marques Moralejo Bermudi, Marcelo Antunes Failla, Oswaldo Santos Baquero, Francisco Chiaravall
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    Gene Reports.2022; 26: 101481.     CrossRef
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    Yuwei Wang, Wang Gao
    IOP Conference Series: Earth and Environmental Science.2020; 568(1): 012009.     CrossRef
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  • Spatial modeling of cutaneous leishmaniasis in Iranian army units during 2014-2017 using a hierarchical Bayesian method and the spatial scan statistic
    Erfan Ayubi, Mohammad Barati, Arasb Dabbagh Moghaddam, Ali Reza Khoshdel
    Epidemiology and Health.2018; 40: e2018032.     CrossRef
Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study
Fatemeh Khosravi Shadmani, Erfan Ayubi, Salman Khazaei, Mohadeseh Sani, Shiva Mansouri Hanis, Somayeh Khazaei, Mokhtar Soheylizad, Kamyar Mansori
Epidemiol Health. 2017;39:e2017020.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017020
  • 15,977 View
  • 280 Download
  • 27 Web of Science
  • 25 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran.
METHODS
This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province.
RESULTS
We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC.
CONCLUSIONS
Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.
Summary

Citations

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    Medical Sciences Journal of Islamic Azad University.2023; 33(3): 230.     CrossRef
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Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran
Fatemeh Khosravi Shadmani, Hamid Soori, Kamyar Mansori, Manoochehr Karami, Erfan Ayubi, Salman Khazaei
Epidemiol Health. 2016;38:e2016038.   Published online August 29, 2016
DOI: https://doi.org/10.4178/epih.e2016038
  • 15,530 View
  • 282 Download
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012.
METHODS
The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs.
RESULTS
Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries.
CONCLUSIONS
This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.
Summary

Citations

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Review
Do the tuberculin skin test and the QuantiFERON-TB Gold in-tube test agree in detecting latent tuberculosis among high-risk contacts? A systematic review and meta-analysis
Erfan Ayubi, Amin Doosti-Irani, Ehsan Mostafavi
Epidemiol Health. 2015;37:e2015043.   Published online October 3, 2015
DOI: https://doi.org/10.4178/epih/e2015043
  • 18,699 View
  • 219 Download
  • 11 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The QuantiFERON-TB Gold in-tube test (QFT-GIT) and the tuberculin skin test (TST) are used to diagnose latent tuberculosis infection (LTBI). However, conclusive evidence regarding the agreement of these two tests among high risk contacts is lacking. This systematic review and meta-analysis aimed to estimate the agreement between the TST and the QFT-GIT using kappa statistics.
METHODS
According to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, scientific databases including PubMed, Scopus, and Ovid were searched using a targeted search strategy to identify relevant studies published as of June 2015. Two researchers reviewed the eligibility of studies and extracted data from them. The pooled kappa estimate was determined using a random effect model. Subgroup analysis, Egger’s test and sensitivity analysis were also performed.
RESULTS
A total of 6,744 articles were retrieved in the initial search, of which 24 studies had data suitable for meta-analysis. The pooled kappa coefficient and prevalence-adjusted bias-adjusted kappa were 0.40 (95% confidence interval [CI], 0.34 to 0.45) and 0.45 (95% CI, 0.38 to 0.49), respectively. The results of the subgroup analysis found that age group, quality of the study, location, and the TST cutoff point affected heterogeneity for the kappa estimate. No publication bias was found (Begg’s test, p=0.53; Egger’s test, p=0.32).
CONCLUSIONS
The agreement between the QFT-GIT and the TST in diagnosing LTBI among high-risk contacts was found to range from fair to moderate.
Summary

Citations

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