Survival Outcomes in Patients with Catheter-Related Bloodstream Infection
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Abstract
Background: Catheter-related bloodstream infection (CRBSI) is one of the most serious complications related to central venous catheter use and is associated with substantial morbidity and mortality. This retrospective cohort study aimed to identify prognostic factors associated with 90-day mortality among patients with CRBSI at Hospital Pakar Universiti Sains Malaysia (HPUSM).
Methods: This retrospective cohort study included 181 patients diagnosed with CRBSI at HPUSM between 2018 and 2022. Time zero was defined as the date of CRBSI diagnosis, while the event of interest was all-cause mortality within 90 days of diagnosis. Cox proportional hazards regression analysis was used to identify factors associated with 90-day mortality.
Results: Of the 181 included patients, 64 (35.4%) died within 90 days of CRBSI diagnosis, while 117 (64.6%) were censored. Factors independently associated with higher mortality risk were sepsis or septic shock (adjusted hazard ratio [aHR] 5.95; 95% confidence interval [CI]: 2.88, 12.28), mechanical ventilation (aHR 5.94; 95% CI: 3.29, 10.71), shorter length of hospital stay (aHR 1.13; 95% CI: 1.10, 1.17), and female sex (aHR 2.71; 95% CI: 1.60, 4.58). Infection caused by Gram-negative organisms was associated with lower mortality risk (aHR 0.31; 95% CI: 0.18, 0.55).
Conclusion: Several clinical and microbiological factors were independently associated with 90-day mortality among patients with CRBSI. These findings may be useful for risk stratification and clinical management of patients with CRBSI.
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