Modelling survival for patients in relation to central venous catheter and nosocomial blood stream infections: a case study of Aga Khan university hospital, Nairobi

Abstract

Background Study was focussed on survival rates of patients admitted in acute care units who utilized medical devices known as Central Venous Catheters (CVC). CVC are useful devices in clinical care, however some infections such as Central Line Associated Bloodstream Infections (CLABSI) may occur which are associated with increased lengths of stay and costs as wells as higher morbidity and mortality rates. Aim The overall objective was to determine the survival probabilities and hazard rates for patients who used CVC devices and compare the subgroups by infection status. Methodology The study was focused on all patients who were admitted in Critical Care Units between 8th December, 2012 and 31st March, 2016 and utilized CVC devices. It was a retrospective study. Survival analysis techniques, test of equality of proportions, Man-Whitney test and Chi–square test of independence were used. Results A total 363 out of 1089 patients included in the study died during hospitalization. 47 patients developed nosocomial CLABSI. The average duration of 18.19 days and median of 12 days was taken by patients who did not develop a nosocomial CLABSI compared to an average of 56.79 days and a median of 51 days for those who developed. There was a significantly higher proportion of mortality by those who developed nosocomial CLABSI compared to the rest (pvalue= 0.01379).The results indicate that there was a significant association between infection status and the event status as well as significant difference between the survival rates of the patients based on infection status. Conclusions There is a significant impact on mortality and morbidity to the patients who develop the nosocomial CLABSI. The length of stay by the patients who developed CLABSI was significantly higher compared to the duration taken by patients who did not develop CLABSI, this leads to increased cost of hospitalization