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The Likelihood of Hospital Readmission among Patients with Hospital-Onset Central Line-Associated Bloodstream Infections
Filetype[PDF - 248.08 KB]


Details:
  • Pubmed ID:
    25990620
  • Pubmed Central ID:
    PMC4702248
  • Funding:
    CC999999/Intramural CDC HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    Objective

    We sought to determine whether central line-associated bloodstream infections (CLABSI) increase the likelihood of readmission.

    Design

    Retrospective matched cohort study for the years 2008–2009.

    Setting

    Acute care hospitals.

    Participants

    Medicare recipients. CLABSI and readmission status were determined by linking National Healthcare Safety Network surveillance data to the Centers for Medicare & Medicaid Services’ Medical Provider and Analysis Review in eight states. Frequency matching was used on ICD-9-CM procedure code category and intensive care unit status.

    Methods

    We compared the rate of readmission among patients with and without CLABSI during an index hospitalization. Cox proportional hazard analysis was used to assess rate of readmission (the first hospitalization within 30 days post-index discharge). Multivariate models included the following covariates: race, sex, length of index hospitalization stay central line procedure code, GAGNE co-morbidity score, and individual chronic conditions.

    Results

    Of the 8,097 patients, 2,260 were readmitted within 30 days (27.9%). The rate of first readmission was 7.1 events/person-year (PY) for CLABSI patients and 4.3 events/PY for non-CLABSI patients (p <0.001). The final model revealed a small but significant increase in the rate of 30 day readmissions for patients with a CLABSI compared to similar non-CLABSI patients. In the first readmission for CLABSI patients, we also observed an increase in diagnostic categories consistent with CLABSI including septicemia and complications of a device.

    Conclusions

    Our analysis found a statistically significant association between CLABSI status and readmission, suggesting that CLABSI may have adverse health impact that extends beyond hospital discharge.