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Prevalence and determinants of infection risk in hospitalised adults: a multicentre cross-sectional study using a structured risk assessment tool

2026-07-23Artigo de investigação Acesso aberto
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorBom, Luís Todo
dc.contributor.authorPragosa, Ângela
dc.contributor.authorMata, Ema
dc.contributor.authorCosteira, Cristina
dc.contributor.authorDuarte, Hugo
dc.contributor.authorMendes, Ana Rita
dc.contributor.authorGonçalves, Telma
dc.contributor.authorMendes, Maria José
dc.contributor.authorCunha, Helena
dc.contributor.authorCunha, Helena
dc.contributor.authorDixe, Maria dos Anjos
dc.contributor.authorMaria dos Anjos Dixe
dc.contributor.authorMarques, Maria do Céu
dc.date.accessioned2026-08-31T14:37:20Z
dc.date.available2026-08-31T14:37:20Z
dc.date.issued2026-07-23en_US
dc.date.updated2026-07-24T08:17:41Z
dc.descriptionArticle number - 1872843.
dc.descriptionAcknowledgments: The authors would like to thank the participating Local Health Units, the nurses involved in data collection, and the Ethics Committees of the participating institutions for their support in carrying out this study. They also acknowledge the collaboration of all healthcare professionals who, directly or indirectly, contributed to the completion of this work.
dc.description.abstractBackground – Healthcare-associated infections remain a major public health challenge, contributing to increased morbidity, mortality, length of hospital stays, and healthcare costs. Systematic assessment of infection risk is essential to support preventive strategies and improve patient safety however remains insufficiently structured in many clinical settings. Objective – To estimate the prevalence of infection risk among hospitalised adults and to identify intrinsic and extrinsic factors associated with high infection risk using a structured risk assessment instrument. Methods – A multicentre, observational, cross-sectional study was conducted in adult inpatient wards across multiple Local Health Units of the Portuguese National Health Service during 2025. Infection risk was assessed using the Risk Assessment for Infection (RAC) scale, which evaluates intrinsic and extrinsic risk factors. Risk stratification was performed using complementary approaches, including receiver operating characteristics (ROC) analysis and percentile-based classification. The study was conducted in accordance with ethical requirements. Results – A total of 1, 092 hospitalised adults were included. Most participants were classified as having moderate (53.6%) or high (11.4%) infection risk according to percentile-based stratification. Higher risk levels were significantly associated with intrinsic factors such as older age, multimorbidity, impaired tissue integrity, and reduced mobility, as well as extrinsic factors including previous hospitalisation, intra- or inter-hospital transfer, prolonged length of stay, invasive procedures, and pharmacological therapy. ROC analysis identified a cut-off point with good discriminative performance, while percentile-based stratification enabled a more granular three-level risk classification. Patients hospitalised in medical wards had significantly higher risk scores compared with those in surgical wards. Conclusion – This study demonstrates a high prevalence of infection risk among hospitalised adults and confirms the multifactorial nature of infection risk in hospital settings. The RAC scale proved to be a useful tool for systematic risk stratification, with the three-level classification providing enhanced clinical applicability. Integrating structured infection risk assessment into routine care may support early identification of high-risk patients, enable targeted preventive interventions, and strengthen infection prevention and control programmes.eng
dc.description.sponsorshipThis work is funded by national funds through the Foundation for Science and Technology, under project UIDP/04923.
dc.description.versionN/A
dc.identifier.citationLuís TB, Ângela P, Ema M, Cristina C, Hugo D, Mendes AR, Telma G, Mendes MJ, Helena C, Ana P, Dixe MA and do Céu MM (2026) Prevalence and determinants of infection risk in hospitalised adults: a multicentre cross-sectional study using a structured risk assessment tool. Front. Public Health 14:1872843. doi: 10.3389/fpubh.2026.1872843
dc.identifier.doi10.3389/fpubh.2026.1872843en_US
dc.identifier.issn2296-2565en_US
dc.identifier.slugcv-prod-5076075
dc.identifier.urihttp://hdl.handle.net/10400.8/16755
dc.language.isoeng
dc.peerreviewedyes
dc.publisherFrontiers Media S.A.
dc.relationComprehensive Health Research Center - Research, Education, Training and Innovation in Clinical research and Public Health
dc.relation.hasversionhttps://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1872843/full
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjecthealthcare-associated infections
dc.subjecthospitalised adults
dc.subjectinfection prevention
dc.subjectinfection risk
dc.subjectnursing assessment
dc.subjectpatient safety
dc.subjectrisk assessment
dc.titlePrevalence and determinants of infection risk in hospitalised adults: a multicentre cross-sectional study using a structured risk assessment tooleng
dc.typeresearch articleen_US
dspace.entity.typePublication
oaire.awardNumberUIDP/04923/2020
oaire.awardTitleComprehensive Health Research Center - Research, Education, Training and Innovation in Clinical research and Public Health
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDP%2F04923%2F2020/PT
oaire.citation.endPage9
oaire.citation.startPage1
oaire.citation.titleFrontiers in Public Healthen_US
oaire.citation.volume14en_US
oaire.fundingStream6817 - DCRRNI ID
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameTodo Bom
person.familyNameda Costa Pragosa
person.familyNameMata
person.familyNameCosteira
person.familyNameDuarte
person.familyNamePereira Cunha
person.familyNameDixe
person.givenNameLuís Filipe Pereira
person.givenNameÂngela Marina
person.givenNameEma
person.givenNameCristina Raquel Batista
person.givenNameHugo Miguel Santos
person.givenNameHelena Margarida
person.givenNameMaria dos Anjos
person.identifier3086129
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person.identifier.ciencia-id5317-5714-6D56
person.identifier.ciencia-id2A12-FBF9-8860
person.identifier.ciencia-id821B-93B2-CCE1
person.identifier.ciencia-idDB15-BD76-2B75
person.identifier.orcid0000-0001-6739-8648
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person.identifier.orcid0009-0005-6894-7780
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person.identifier.orcid0009-0009-5492-5598
person.identifier.orcid0000-0001-9035-8548
person.identifier.ridB-9257-2018
person.identifier.scopus-author-id57200547379
person.identifier.scopus-author-id57277177100
person.identifier.scopus-author-id55885797900
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.cv.cienciaid5317-5714-6D56 | Cristina Raquel Batista Costeira
rcaap.rightsopenAccessen_US
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