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CLABSIs increase risk of hospital readmission
Central line-associated bloodstream infection may be associated with increased risk of hospital readmission, according to recent findings.
“There are few studies specifically examining the issue of [central line-associated bloodstream infection (CLABSI)] and hospital readmissions,” the researchers wrote. “If confirmed, our findings further reinforce the need to prevent CLABSI because this may benefit beyond the index visit, though the total burden of readmissions attributable to CLABSI may not be large.”
In the retrospective, matched-control study, researchers examined data from the National Healthcare Safety Network (NHSN) to identify 917 cases of hospital-onset CLABSI among Medicare enrollees. The study population included individuals aged 64 years and older who were admitted to the hospital between Jan. 1, 2008 and Dec. 31, 2009. Electronic data were collected regarding admission dates, patient date of birth, gender, facility and location, and CLABSIs were defined using standard NHSN protocol. Also included in the analysis were 7,180 frequency-matched control patients without CLABSI.
The researchers defined the primary outcome of the study as hospital readmissions between 1 to 30 days after initial hospital discharge. The secondary outcome was defined as the first hospital readmission after the original hospitalization.
There was a 27.9% rate of readmission within 30 days among all included cases. CLABSI patients had a first readmission rate of 7.1 events per person-year, while non-CLABSI patients had a reduced first readmission rate of 4.3 events per person year (P < .001), according to the researchers. Patients with a CLABSI had a 1.8 times higher overall rate of readmission compared to those without a CLABSI (incidence rate ratio [IRR] = 1.8; 95% CI, 1.6-1.9). After adjusting for possible confounding factors, the researchers identified a borderline significant correlation between CLABSI and 30-day readmission (IRR = 1.2; 95% CI, 1.0-1.3). Further analysis suggested a borderline relationship between CLABSI and all readmissions (IRR = 1.1; 95% CI, 1.0-1.2).
“Prevention of CLABSI may therefore reduce patient burden and health care costs associated not only with hospitalizations during which CLABSIs occur, but also by prevention of a proportion of subsequent readmissions to the hospital and their associated costs,” the researchers wrote – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.