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On the Role of Length of Stay in Healthcare-Associated Bloodstream Infection

  • Christie Y. Jeon (a1) (a2), Matthew Neidell (a3), Haomiao Jia (a1), Matt Sinisi (a1) and Elaine Larson (a1)...

Abstract

Design.

We conducted a retrospective cohort study to examine the role played by length of hospital stay in the risk of healthcare-associated bloodstream infection (BSI), independent of demographic and clinical risk factors for BSI.

Patients.

We employed data from 113,893 admissions from inpatients discharged between 2006 and 2008.

Setting.

Large tertiary healthcare center in New York City.

Methods.

We estimated the crude and adjusted hazard of BSI by conducting logistic regression using a person-day data structure. The covariates included in the fully adjusted model included age, sex, Charlson score of comorbidity, renal failure, and malignancy as static variables and central venous catheterization, mechanical ventilation, and intensive care unit stay as time-varying variables.

Results.

In the crude model, we observed a nonlinear increasing hazard of BSI with increasing hospital stay. This trend was reduced to a constant hazard when fully adjusted for demographic and clinical risk factors for BSI.

Conclusion.

The association between longer length of hospital stay and increased risk of infection can largely be explained by the increased duration of stay among those who have underlying morbidity and require invasive procedures. We should take caution in attributing the association between length of stay and BSI to a direct negative impact of the healthcare environment.

Copyright

Corresponding author

650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095 (christie.jeon@gmail.com)

References

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On the Role of Length of Stay in Healthcare-Associated Bloodstream Infection

  • Christie Y. Jeon (a1) (a2), Matthew Neidell (a3), Haomiao Jia (a1), Matt Sinisi (a1) and Elaine Larson (a1)...

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