Length of Stay in Patients With Central Line-Associated Bloodstream Infection at a Tertiary Hospital in the Kingdom of Saudi Arabia

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Abstract

Objective

To examine the impact of central line-associated bloodstream infection (CLABSI) on hospital length of stay (LOS) and to identify the factors associated with prolonged LOS.

Methods

The research setting was King Saud University Medical City (KSUMC) in Riyadh, Kingdom of Saudi Arabia. A retrospective cohort design was applied with a sample of adult CLABSI patients. Patients developed CLABSI following central line insertion at KSUMC between March 2016 and February 2018.

Results

The CLABSI-related prolongation of LOS was 13.13 ± 9.53 days for a total of 283 patients. This figure rose for patients with any CLABSI-related sequela, and the result was statistically significant (p<0.033). It was also significantly higher in patients with delayed central line removal (p<0.001). A patient’s setting (i.e., in the intensive care unit prior to or following infection) was not a factor associated with prolonged LOS. Nevertheless, the requirement for inotropes after the infection was linked to prolonged LOS in a statistically significant way (p<0.048).

Conclusions

For ill patients who need hemodynamic support following infection, CLABSI can significantly increase hospital LOS. Delayed decisions or slow central line removal are associated with significant increases in LOS.

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Most cited references 20

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Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.

Craig A Umscheid, Matthew D. Mitchell, Jalpa Doshi … (2011)

To estimate the proportion of healthcare-associated infections (HAIs) in US hospitals that are "reasonably preventable," along with their related mortality and costs. To estimate preventability of catheter-associated bloodstream infections (CABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), and ventilator-associated pneumonia (VAP), we used a federally sponsored systematic review of interventions to reduce HAIs. Ranges of preventability included the lowest and highest risk reductions reported by US studies of "moderate" to "good" quality published in the last 10 years. We used the most recently published national data to determine the annual incidence of HAIs and associated mortality. To estimate incremental cost of HAIs, we performed a systematic review, which included costs from studies in general US patient populations. To calculate ranges for the annual number of preventable infections and deaths and annual costs, we multiplied our infection, mortality, and cost figures with our ranges of preventability for each HAI. As many as 65%-70% of cases of CABSI and CAUTI and 55% of cases of VAP and SSI may be preventable with current evidence-based strategies. CAUTI may be the most preventable HAI. CABSI has the highest number of preventable deaths, followed by VAP. CABSI also has the highest cost impact; costs due to preventable cases of VAP, CAUTI, and SSI are likely less. Our findings suggest that 100% prevention of HAIs may not be attainable with current evidence-based prevention strategies; however, comprehensive implementation of such strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars.

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R W Haley, D H Culver, J. W. White … (1985)

In a representative sample of US general hospitals, the authors found that the establishment of intensive infection surveillance and control programs was strongly associated with reductions in rates of nosocomial urinary tract infection, surgical wound infection, pneumonia, and bacteremia between 1970 and 1975-1976, after controlling for other characteristics of the hospitals and their patients. Essential components of effective programs included conducting organized surveillance and control activities and having a trained, effectual infection control physician, an infection control nurse per 250 beds, and a system for reporting infection rates to practicing surgeons. Programs with these components reduced their hospitals' infection rates by 32%. Since relatively few hospitals had very effective programs, however, only 6% of the nation's approximately 2 million nosocomial infections were being prevented in the mid-1970s, leaving another 26% to be prevented by universal adoption of these programs. Among hospitals without effective programs, the overall infection rate increased by 18% from 1970 to 1976.

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Author and article information

Journal

Journal ID (nlm-ta): Cureus

Journal ID (iso-abbrev): Cureus

Journal ID (issn): 2168-8184

Title: Cureus

Publisher: Cureus (Palo Alto (CA) )

ISSN (Electronic): 2168-8184

Publication date (Electronic, pub): 6 October 2020

Publication date (Electronic, collection): October 2020

Volume: 12

Issue: 10

Electronic Location Identifier: e10820

Affiliations

[1 ] Infectious Disease, King Saud University, College of Medicine, Riyadh, SAU

[2 ] Internal Medicine, King Saud University, College of Medicine, Riyadh, SAU

[3 ] Internal Medicine, Alfaisal University College of Medicine, Riyadh, SAU

Author notes

Abdulrahman Barri barri11311@ 123456gmail.com

Article

DOI: 10.7759/cureus.10820

PMC ID: 7645296

SO-VID: f71ea113-62c1-411a-b1d2-691ebb506102

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Length of Stay in Patients With Central Line-Associated Bloodstream Infection at a Tertiary Hospital in the Kingdom of Saudi Arabia

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Abstract

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Most cited references 20

Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.

Guidelines for the prevention of intravascular catheter-related infections.

The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals.

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