Number of CVCs % of total number of CVCs Number of CVC days Catheter‐related bloodstream infection Incidence rate per 1000 CVC‐ days 95% CIa Use Parenteral nutrition Dialysis Hemodynamic monitoring Antibiotics Other (none of above) 736 413 1999 1760 1931 19.6 11.0 53.3 46.9 51.5 7197 3336 13,897 13,858 14,160 3.1 3.9 1.5 1.6 1.6 (1.9 – 4.6) (2.1 – 6.7) (0.9 – 2.3) (1.0 – 2.4) (1.0 – 2.4) a 95% CI according to Rothman/Greenland. With zero infections in a category the Byar poisson approach was used. b 1 = suited for low complex patients; 3 = suited for high complex patients c CVC insertion not necessarily directly after ICU stay d Either a ICU admission or ICU discharge date were known but not both. One hospital did not collect ICU discharge dates, contributing to 272 of these 279 cases. Table II: Risk factors for the development of catheter‐related bloodstream infection in univariate and multi‐variate Cox regression analyses. Univariate analysis Multivariate analysis Hazard ratio 95% CI Hazard ratio 95% CI Insertion vein Subclavian vein Jugular vein Femoral vein Ref.£ 1.7 2.0** 0.9 ‐ 3.3 1.1 ‐ 3.7 Ref. a 1.9* 2.0** 1.0 ‐ 3.8 1.0 ‐ 3.8 Antibiotics through CVC 0.6 0.4 ‐ 1.1 0.5** 0.3 ‐ 0.9 Parenteral nutrition through CVC 1.5 0.9 ‐ 2.5 2.3** 1.3 ‐ 4.1 Duration of ICU stay until CVC insertion 0 days (no ICU stay) 1 ‐ 5 days 6 ‐ 20 days > 20 days not determinableb Ref. 3.0** 4.5** 1.7 2.3 1.1 ‐ 8.7 1.5 ‐ 13.3 0.4 ‐ 7.4 0.4 ‐ 12.9 Ref. 4.4** 6.6** 2.4 2.5 1.2 ‐ 16.1 1.7 ‐ 25.5 0.4 ‐ 12.9 0.4 ‐ 16.5 Dialysis through CVC 2.2** 1.2 ‐ 4.0 Other CVC use (Other than TPN, dialysis, AB or hemodynamic monitoring) 0.7 0.4 ‐ 1.2 ICU level (complexity of care) 2 3 Ref. 1.8* 0.9 ‐ 3.6 All variables with p < 0.2 were included in the initial multivariate regression model and are shown here. Results of the multivariate analysis were corrected for confounding by the variable lumen (single versus multilumen). a Reference b Either a ICU admission or ICU discharge date were known but not both. ** p = < 0.05 * 0.05 < p <0.1 50 Chapter 3
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