Evaluation of outcome of intravenous catheter-related infections in critically ill patients

Fifty-seven patients developed an episode of catheter-related infection (CR I) in the bloodstream during their stay in the intensive care unit (cases) and were prospectively observed to establish the attributable mortality, In crease in length of stay, and excess costs. Costs were estimated by multipl ying the number of excess days of stay by the reimbursement provided. The o utcomes for these cases were compared with those for matched control subjec ts without CRI. Eight cases were excluded as no control was found. Of the 4 9 cases, 31 were coagulase-negative staphylococci (CNS), The level of sever ity was similar for both groups (APACHE II 15.5 +/- 7.2 versus 15.2 +/- 7.3 ). There were no significant differences (p > 0.20) in the mortality observ ed in the hospital for the cases (22.4%, 95% confidence interval [CI] 0.3% to 34.9%) and the control subjects (34.7%, 95% CI 21.2% to 40.1%), Among th e survivors, the hospital stay was increased by 19.6 d (95% CI -1.1; 40.4). This represents an added cost of 3,124 Euros per episode of CRI among the survivors. In conclusion, our cohort study failed to show a difference in a ttributable mortality due to CRI in intensive care unit patients. Neverthel ess, these infections lead to an increase in hospital stay of approximately 20 d. Each episode of CRI represents an additional cost of more than 3,000 Euros.