Journal of Hospital Infection (1996) 32, 117-l 26 Prospective survey of the incidence, risk factors and outcome of hospital-acquired infections in the elderly M. Hussain, B. A. Oppenheim, P. O’Neill*, C. Trembatht, J. Morrist and M. A. Horan* Public Health Laboratory, *University Department of Geriatric Medicine, +Department of Clinical Audit and SDepartment of Medical Statistics, Withington Hospital, West Didsbury, Manchester M20 2LR, UK Received 18 July 1995; revised manuscript accepted for publication 31 August 1995 Summary: Four hundred and thirty-six patient admissions to either an acute assessment or a rehabilitation ward for the care of the elderly were studied. A total of 113 episodes fitting the definition of a hospital-acquired infection (HAI) occurred in 81 (18.W) f d o o a missions. The global infection rate was 10.8 per 1000 patient bed days and did not differ between the wards. The chest and urinary tract were the commonest sites of infection, and 26 patients appeared to be infected at more than one site. The majority of first infections occurred within 14 days of admission. Median length of stay for patients with one or more infective episodes was significantly longer than for those who did not develop an HAI. The presence of an HAI, multiple-site infections and chest infections were significantly associated with fatal outcome. HA1 occurs commonly in elderly patients and is associated with prolonged hospital stay and increased mortality. Keywords: Hospital-acquired infection; infection rate; care of the elderly. Introduction Hospital-acquired infections (HAIs) are a major source of morbidity and mortality. In the only large prevalence study performed in the UK infections were judged to be present in 19.1% of patients, and in 9.9% the infection was considered to be an HAI.’ HAIs may rank among the 10 leading causes of death in the USA.’ Elderly patients experience a greater incidence, mortality, and cost at- tributable to HAI. Data from the Center for Disease Control have shown that patients aged 65 years and older account for more than half the cases, Correspondence to: B. A. Oppenheim. 0195-6701/96/020117+10 $12.00/O 117 Q 1996 The Hospital Infection Society