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Inventi Impact: Clinical Nursing

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  • Inventi:hcln/29270/19
    The Clinical Impacts and Risk Factors for Non-Central Line-Associated Bloodstream Infection in 5046 Intensive Care Unit Patients: An Observational Study Based on Electronic Medical Records
    Research 2019 : July - September
    Shichao Zhu, Yan Kang, Wen Wang, Lin Cai, Xin Sun, Zhiyong Zong

    Background: Most of the previous studies focused on central line-associated bloodstream infection (CLABSI), while\nnon-central line-associated bloodstream infection (N-CLABSI) was poorly studied. This study was performed to\ninvestigate the clinical impacts and risk factors for N-CLABSI in intensive care unit (ICU) patients.\nMethods: An observational study was conducted in an adult general ICU. The electronic medical records from 2013\nto 2017 of all patients agedless than equal to 18 years admitted to the ICU > 2 days were analyzed retrospectively. Patients with NCLABSI\nand without N-CLABSI or with CLABSI were compared for clinical features and outcomes. Predicted death in\nICU included death in ICU and discharging from ICU against medical advice because of critical conditions and the\ndesire to pass away at home. Propensity score (PS) matching was used to ensure that both two groups had similar\nbaseline characteristics. Multivariate regression models were used to confirm whether N-CLABSI was an\nindependent risk factor for each of the outcomes and to analyze the risk factors for N-CLABSI in ICU patients.\nResults: Of 5046 patients included, 155 developed 168 ICU-acquired N-CLABSI episodes (2.1 episodes per 1000\npatient-days) in the ICU, accounted for the majority of nosocomial bloodstream infections (NBSIs; 71.8%). After PS\nmatching, patients with N-CLABSI had prolonged length of stay (LOS) in ICU (median 15 days, p < 0.001) and LOS\nin hospital (median 13 days, p < 0.001), excess hospitalization costs (median, dollar 27,668 [in US dollar 2017, 1:6.\n75], p < 0.001), and increased mortality in ICU (8.8%, p = 0.013) and predicted mortality in ICU (22.7%, p< 0.\n001), compared with those without N-CLABSI. There were no significant differences in all the outcomes\nbetween\nN-CLABSI and CLABSI. N-CLABSI was an independent risk factor for each of the outcomes. Gastrointestinal\nbleeding (adjusted odds ratio [aOR] 2.30), trauma (aOR 2.52), pancreatitis (aOR 3.45), surgical operation (aOR\n1.82), intravascular catheters (aOR 2.93), sepsis (aOR 1.69), pneumonia (aOR 1.53), intraabdominal infection (IAI,\naOR 8.37), or healthcare-associated infections other than NBSI, pneumonia, and IAI (aOR 3.89) were risk factors\nfor N-CLABSI in ICU patients.

    How to Cite this Article
    Attribution/ CC Compliant Citation: Zhu, Shichao, et al. \"The\nclinical impacts and risk factors for non-central lineassociated\nbloodstream infection in 5046 intensive care unit\npatients: an observational study based on electronic medical\nrecords.\" Critical Care 23.1 (2019): 52.\nhttps://doi.org/10.1186/s13054-019-2353-5\nhttp://creativecommons.org/licenses/by/4.0/\n\nSome formatting elements, header, footer, logos, dates and\npagination were modified while adapting this article.
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