Catheter-related sepsis in critically ill and associated mortality
Abstract number: 902_p867
Catheter-related infection (CRI) is considered as a cause of increased Hospital morbidity but its influence on Hospital mortality remains a matter of debate. In critically ill patients, baseline severity, underlying conditions and various confounding factors may explain the observed increased mortality rather than CRI itself. In order to determine the influence of CRI on Hospital mortality in ICU, all episodes of nosocomial septicaemia were reviewed.
Material and methods:
Retrospective analysis of all nosocomial septicaemia occurring over a 7-year period in a teaching Hospital. Septicaemia episodes were separated in secondary, primary and proven catheter-related bloodstream infections. Baseline severity (SAPS score), delay between admission and infection, and Hospital mortality were determined.
Over this 7-year period, 195 853 patients were admitted to the Hospital and 2720 episodes of CRI were recorded (1.38%, 1.5/1000 Catheter-day (KTD)). Hospital mortality for all septicaemia was 21.7% while mortality related to secondary septicaemia was 28.5% (P < 0.05). During the same period, 22 313 patients were admitted to the ICU, corresponding to 81 740 KTD. Four hundred twenty-four episodes of septicaemia occurred in these patients (5/1000 KTD), of which 166 were primary septicaemia and 87 were proven CRI (1.06/1000 KTD). Mean SAPS score for all ICU patients was 30 and Hospital mortality 6.9%. ICU patients developing infection had a mean baseline SAPS score >40. CRI occurred more than 2 weeks after ICU admission (median : 14 days, mean 20.5 days). Pathogen-associated CRI were SCN 31%, S. Aureus 18%, E. faecalis 12%, Candida spp. 10%, Other 29%. Hospital mortality in patients developing CRI was 42/87 (48.2%).
In this study, Hospital mortality in Critically Ill patients developing CRI was high but seemed to be primarily determined by baseline severity and underlying conditions as reflected by SAPS score and prolonged delay between ICU admission and septicaemia."
|Session name:||XXIst ISTH Congress|
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