scholarly journals Attributable Cost and Length of Stay for Patients With Central Venous Catheter—Associated Bloodstream Infection in Mexico City Intensive Care Units A Prospective, Matched Analysis

2007 ◽  
Vol 28 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Francisco Higuera ◽  
Manuel Sigfrido Rangel-Frausto ◽  
Victor Daniel Rosenthal ◽  
Jose Martinez Soto ◽  
Jorge Castañon ◽  
...  

Background.No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico.Objective.To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City.Design.An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI.Setting.Adult ICUs in 3 hospitals in Mexico City.Patients and Methods.A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments.Results.For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was $598, the mean extra hospital cost was $11,591, and the attributable extra mortality was 20%.Conclusions.In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.

2016 ◽  
Vol 29 (6) ◽  
pp. 373
Author(s):  
Jorge Rodrigues ◽  
Andrea Dias ◽  
Guiomar Oliveira ◽  
José Farela Neves

<p><strong>Introduction:</strong> To determine the central-line associated bloodstream infection rate after implementation of central venous catheter-care practice bundles and guidelines and to compare it with the previous central-line associated bloodstream infection rate.<br /><strong>Material and Methods:</strong> A prospective, longitudinal, observational descriptive study with an exploratory component was performed in a Pediatric Intensive Care Unit during five months. The universe was composed of every child admitted to Pediatric Intensive Care Unit who inserted a central venous catheter. A comparative study with historical controls was performed to evaluate the result of the intervention (group 1 <em>versus</em> group 2).<br /><strong>Results:</strong> Seventy five children were included, with a median age of 23 months: 22 (29.3%) newborns; 28 (37.3%) with recent surgery and 32 (43.8%) with underlying illness. A total of 105 central venous catheter were inserted, the majority a single central venous catheter (69.3%), with a mean duration of 6.8 ± 6.7 days. The most common type of central venous catheter was the short-term, non-tunneled central venous catheter (45.7%), while the subclavian and brachial flexure veins were the most frequent insertion sites (both 25.7%). There were no cases of central-line associated bloodstream infection reported during this study. Comparing with historical controls (group 1), both groups were similar regarding age, gender, department of origin and place of central venous catheter insertion. In the current study (group 2), the median length of stay was higher, while the mean duration of central venous catheter (excluding peripherally inserted central line) was similar in both groups. There were no statistical differences regarding central venous catheter caliber and number of lumens. Fewer children admitted to Pediatric Intensive Care Unit had central venous catheter inserted in group 2, with no significant difference between single or multiple central venous catheter.<br /><strong>Discussion:</strong> After multidimensional strategy implementation there was no reported central-line associated bloodstream infection<br /><strong>Conclusions:</strong> Efforts must be made to preserve the same degree of multidimensional prevention, in order to confirm the effective reduction of the central-line associated bloodstream infection rate and to allow its maintenance.</p>


Critical Care ◽  
2008 ◽  
Vol 12 (Suppl 5) ◽  
pp. P7
Author(s):  
Sonja Hansen ◽  
Frank Schwab ◽  
Sandra Schneider ◽  
Dorit Sohr ◽  
Christine Geffers ◽  
...  

2005 ◽  
Vol 26 (8) ◽  
pp. 715-719 ◽  
Author(s):  
Mary-Louise McLaws ◽  
Geoffrey Berry

AbstractObjective:To determine whether the conventional rate for central venous catheter (CVC)-associated bloodstream infection (BSI) accurately reflects risk for patients exposed for a variety of in situ periods.Patients and Methods:Intensive care unit patients (n = 1,375) were monitored for 7,467 CVC-days. They were monitored until catheter removal, until diagnosis of CVC-associated BSI, or for 24 hours after discharge.Results:The BSI rate was 3.7 per 1,000 CVC-days. Ninety-three percent of these patients had CVCs in situ for 1-15 days. These patients were exposed to 59.7% of all CVC-days; the remaining 7% were exposed to 40.3% of all CVC-days. BSI rates stratified by exposure periods of 1-5 and 6-15 days were 2.1 and 4.5 per 1,000 CVC-days, respectively. The rates for 16-30 and 31-320 days were 10.2 and 2.1 per 1,000 CVC-days, respectively. The probability of BSI with a CVC in situ was 6 in 100 by day 15, 14 in 100 by day 25, 21 in 100 by day 30, and 53 in 100 by day 320.Conclusion:The conventional aggregated rate better reflects the risk for the majority of patients rather than for patients exposed to the majority of CVC-days. It does not reflect the true probability of risk for all exposures, especially beyond 30 days. CVCs in situ from 1 to 15 days had less risk of BSI than CVCs in situ more than 15 days, which may explain why scheduled CVC replacement at days 5 to 7 has not been found beneficial.


Sign in / Sign up

Export Citation Format

Share Document