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Excess Length of Stay Due to Central Line–Associated Bloodstream Infection in Intensive Care Units in Argentina, Brazil, and Mexico

Published online by Cambridge University Press:  02 January 2015

Adrian G. Barnett*
Affiliation:
Institute of Health and Biomedical Innovation and School of Public Health, Queensland University of Technology, Kelvin Grove, Australia
Nicholas Graves
Affiliation:
Institute of Health and Biomedical Innovation and School of Public Health, Queensland University of Technology, Kelvin Grove, Australia
Victor D. Rosenthal
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
Reinaldo Salomao
Affiliation:
Santa Marcelina Hospital, Sao Paulo, Brazil
Manuel Sigfrido Rangel-Frausto
Affiliation:
Specialties IMSS Hospital, Mexico City, Mexico
*
Institute of Health and Biomedical Innovation and School of Public Health, 60 Musk Avenue, Queensland University of Technology, Kelvin Grove, Australia, (a.barnett@qut.edu.au)

Extract

Objective.

To estimate the excess length of stay in an intensive care unit (ICU) due to a central line-associated bloodstream infection (CLABSI), using a multistate model that accounts for the timing of infection.

Design.

A cohort of 3,560 patients followed up for 36,806 days in ICUs.

Setting.

Eleven ICUs in 3 Latin American countries: Argentina, Brazil, and Mexico.

Patients.

All patients admitted to the ICU during a defined time period with a central line in place for more than 24 hours.

Results.

The average excess length of stay due to a CLABSI increased in 10 of 11 ICUs and varied from -1.23 days to 4.69 days. A reduction in length of stay in Mexico was probably caused by an increased risk of death due to CLABSI, leading to shorter times to death. Adjusting for patient age and Average Severity of Illness Score tended to increase the estimated excess length of stays due to CLABSI.

Conclusions.

CLABSIs are associated with an excess length of ICU stay. The average excess length of stay varies between ICUs, most likely because of the case-mix of admissions and differences in the ways that hospitals deal with infections.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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