Global incidence and risk factors for injury-related bloodstream infections: a scoping review

Bloodstream infection (BSI) can be a serious complication among injured patients. Understanding the burden of injury-related BSI is important for early detection and implementing appropriate treatments to improve patient outcomes. Incidence rates and risk factors are important measures that help provide insights into the burden of injury-related BSIs and early diagnosis of patients. In this review, the aim was to comprehensively summarize incidence rates and risk factors for injury-related BSIs from scientific literature. Four electronic databases (PubMed, CINAHL [via EBSCOhost], Embase, and Web of Science) were searched. There were no limitations on the language. Studies reporting the incidence rates or risk factors associated with incidence or adverse outcomes from injury-related BSIs were included. Database searches returned 9830 articles, of which 48 were included. Incidence rates of injury-related BSIs ranged from 0.71 to 27.4 episodes per 1000 patient-days. A total of 237 potential factors associated with the development and/or outcomes of injury-related BSIs were identified and classified into 8 broad categories: demographics, prognostic scores, burn extent, clinical and patient health factors, biomarkers, resource utilization and treatments, pathogens and injuries, and mechanisms. Older age, male sex, higher injury severity score, longer length of stay, greater total body surface burn area, and inhalation injuries were the most frequently reported risk factors. This review identified a large variation in reported incidence rates but no population-based studies. Many factors have been associated with injury-related BSIs; however, the direction of association and effect sizes vary across the studies, which can be attributed to the differences in study design.