OBJECTIVE: This retrospective study analyzed the risk factors, predictors, causative organisms, and impact of CLABSI on clinical outcomes mortality, and length of stay (LOS) in older adults.
METHODS: We included 36 patients diagnosed with CLABSI according to the Centers for Disease Control and Prevention criteria at King Abdulaziz University Hospital during 2013-2014 cases and 375 control patients controls. Risk factors were evaluated using a multivariate logistic regression analysis.
RESULTS: Cases and controls did not differ significantly in age or sex distribution. However, cases had a significantly longer LOS than controls 78 vs. 19 days, p < 0.001. One-third of 12/36 CLABSI cases were admitted to the medical intensive care unit (MICU). Most had renal disease, acute coronary syndrome, and used steroids. Additionally, 34 cases (94.4%) and 2 cases (5.6%) presented with primary and secondary infections, respectively, and hypotension was the most prevalent symptom (12/36). The internal jugular vein was the most common insertion site, and the nasogastric tube and mechanical ventilator were the most common insertion devices. Seven cases died, and three deaths were attributed to bloodstream infection (BSI). The most common cause of blood infection was Staphylococcus epidermidis, followed by Klebsiella pneumoniae.
CONCLUSIONS: The present study reveals age, LOS, total parenteral nutrition/partial parenteral nutrition (TPN/PPN), and transplantation as the independent risk factors/predictors of CLABSI.
目的:本回顾性研究分析了危险因素,预测因子,致病生物,以及CLABSI对临床结局死亡率的影响,以及老年人的住院时间(LOS)。
方法:我们纳入了根据2013-2014年阿卜杜勒阿齐兹国王大学医院疾病控制和预防中心标准诊断为CLABSI的36例患者和375例对照患者。使用多变量逻辑回归分析评估危险因素。
结果:病例和对照组在年龄或性别分布上没有显著差异。然而,病例的LOS明显长于对照组78vs.19天,p<0.001。12/36例CLABSI病例中有三分之一被送往医疗重症监护病房(MICU)。大多数人患有肾脏疾病,急性冠脉综合征,并使用类固醇。此外,34例(94.4%),2例(5.6%)出现原发和继发感染,分别,低血压是最常见的症状(12/36)。颈内静脉是最常见的插入部位,鼻胃管和机械呼吸机是最常见的插入装置。7例死亡,3例死亡归因于血流感染(BSI)。血液感染最常见的原因是表皮葡萄球菌,其次是肺炎克雷伯菌。
结论:本研究揭示了年龄,LOS,全胃肠外营养/部分胃肠外营养(TPN/PPN),和移植作为CLABSI的独立危险因素/预测因子。