Analysis of risk factors of central venous catheter-related bloodstream infection

TANG Chunyan; LUO Dan; CHEN Qian; LI Wei

doi:10.12173/j.issn.1004-5511.202310099

Abstract：Objective To explore the risk factors for the development of central venous catheter-related bloodstream infections(CRBSI).Methods The clinical data of patients undergoing central venous catheterization in The People's Hospital of Jianyang City from February 2019 to February 2023 were retrospective and analyzed,and they were divided into CRBSI group and non-CRBSI group.Basic data of the two groups were compared.The risk factors for CRBSI were determined by multivariate Logistic regression analysis.A predictive model for CRBSI patient was construsted through receiver operating characteristic curves(ROC).Results A total of 304 patients were included,including 47(15.46％)in the CRBSI group and 257(84.54％)in the non-CRBSI group.The age,BMI,and APACHE Ⅱ score in the CRBSI group were significantly higher than the non-CRBSI group,and the catheterization time was significantly longer than the non-CRBSI group.The proportion of diabetes mellitus,ICU site,internal jugular vein or femoral vein were significantly higher than that in the non-CRBSI group,and the differences were statistically significant(P＜0.05).Multifactor Logistic analysis indicated that older age[OR=3.067,95％CI(1.238,7.598)],high BMI[OR=1.894,95％CI(1.215,2.952)],coexistence of diabetes[OR=1.609,95％CI(1.129,2.293)],high APACHE Ⅱ score[OR=2.287,95％CI(1.174,4.455)],catheterization location in the ICU[OR=4.106,95％CI(1.600,10.537)],catheterization site being the internal jugular or femoral vein[OR=3.416,95％CI(1.583,7.371)],and prolonged catheterization duration[OR=1.416,95％CI(1.019,1.968)]were risk factors for CRBSI in patients.According to ROC analysis,age,BMI,APACHE Ⅱ score,catheterization time and multivariate Logistic regression model were all used for the prediction of CRBSI in patients with central venous catheterization,and the multivariate Logistic regression model can obtain higher area under the curve[AUC=0.981,95％CI(0.967,0.996)],sensitivity(0.957)and specificity(0.961).Conclusion The occurrence of CRBSI in patients with central venous catheters is influenced by factors such as age,BMI,APACHE Ⅱ score,catheterization site,catheterization site location,and duration of catheterization.It is important to consider these factors comprehensively,to take timely and appropriate intervention measures,and to prevent as early as possible in clinical practice.