a1 Institute of Health and Biomedical Innovation and School of Public Health, Queensland University of Technology, Kelvin Grove, Australia
a2 International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
a3 Santa Marcelina Hospital, Sao Paulo, Brazil
a4 Specialties IMSS Hospital, Mexico City, Mexico
Objective. To estimate the excess length of stay in an intensive care unit (ICU) due to a central line-associated bloodstream infection (CLABSI), using a multistate model that accounts for the timing of infection.
Design. A cohort of 3,560 patients followed up for 36,806 days in ICUs.
Setting. Eleven ICUs in 3 Latin American countries: Argentina, Brazil, and Mexico.
Patients. All patients admitted to the ICU during a defined time period with a central line in place for more than 24 hours.
Results. The average excess length of stay due to a CLABSI increased in 10 of 11 ICUs and varied from -1.23 days to 4.69 days. A reduction in length of stay in Mexico was probably caused by an increased risk of death due to CLABSI, leading to shorter times to death. Adjusting for patient age and Average Severity of Illness Score tended to increase the estimated excess length of stays due to CLABSI.
Conclusions. CLABSIs are associated with an excess length of ICU stay. The average excess length of stay varies between ICUs, most likely because of the case-mix of admissions and differences in the ways that hospitals deal with infections.
(Received February 26 2010)
(Accepted May 19 2010)