Incidence, Risk Factors, and Outcomes of Central Line-Associated Bloodstream Infections in Trauma Patients

Area of Science:

• Medical Research
• Infectious Diseases
• Trauma Surgery

Background:

• Central line-associated blood stream infection (CLABSI) is a significant hospital-acquired infection (HAI) with high morbidity and mortality.
• Limited data exists on CLABSI incidence, outcomes, and risk factors specifically within the trauma patient population.

Purpose of the Study:

• To determine the incidence rate of CLABSI in trauma patients.
• To identify risk factors associated with developing CLABSI in this cohort.

Main Methods:

• Utilized the 2017-2021 Trauma Quality Improvement Program database.
• Included trauma patients aged 18 years or older requiring central line placement.
• Performed bivariate and multivariable logistic regression analyses comparing CLABSI (+) and (-) patients.

Main Results:

• Out of 175,538 patients, 469 (<0.1%) developed CLABSI.
• CLABSI patients exhibited higher rates of cirrhosis and chronic kidney disease (CKD).
• CLABSI was associated with increased injury severity, length of stay (LOS), ICU LOS, and mortality.
• Independent risk factors included other HAIs (CAUTI, VAP, SSI), small intestine injury, CKD, and cirrhosis.

Conclusions:

• Despite a low incidence (<0.1%), CLABSI significantly worsens outcomes in trauma patients.
• Hospital-acquired infections (CAUTI, VAP, SSI), small intestine injuries, and comorbidities are major risk factors for CLABSI.
• Awareness and targeted prevention strategies for these risk factors are crucial for mitigating CLABSI in trauma care.