Unit:
Τομέας Χειρουργικός - ΝοσηλευτικόςLibrary of the School of Health Sciences
Author:
Tsolakoglou Ioannis
Dissertation committee:
Φιλντίσης Γεώργιος. Καθηγητής, Νοσηλευτική ,ΕΚΠΑ
Τσουμάκας Κωνσταντίνος, Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Ελευσινιώτης Ιωάννης, Αναπληρωτής Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Μυριανθεύς Παύλος, Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Κατσούλας Θεόδωρος, Επίκουρος Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Μαριόλης - Σαψάκος Θεόδωρος, Επίκουρος Καθηγητής , Νοσηλευτική ,ΕΚΠΑ
Φώτος Νικόλαος, Επίκουρος Καθηγητής, Νοσηλευτική ,ΕΚΠΑ
Original Title:
Ο ρόλος της παχυσαρκίας στην εμφάνιση λοιμώξεων σχετιζόμενων με κεντρικούς φλεβικούς καθετήρες
Translated title:
The role of obesity in central line-associated bloodstream infections
Summary:
Introduction: About 48% of all ICU patients have central venous catheters (CVCs) that translate to about 15 million catheterization days per year. The most common risk associated with CVCs are the CLABSIs caused by microorganisms that colonize the external surface of the device or the lumen through which the fluid passes when the device is inserted or during its use.
Aim: The aim of this study was to investigate the incidence of obesity in the development of CLABSI.
Methodology: This is a prospective observational study, which took place in three hospitals. The collection of data lasted for 18 months and included patients who were hospitalized in ICU. Excluded all patients who died within 48 hours of their admission to ICU, patients who for any reason could not measure an obesity assessment parameter, and patients who had not been classified by a severity-of-disease classification system. Statistical analysis of the data was done with the SPSS for Windows statistical software (SPSS Inc., Chicago, IL).
Results: The study sample consisted of 372 patients with central line catheter aged 63.6±16.6 years, APACHE II 23.3±6.9 and MODS 7.5±3.8. A total of 174 (46.8%) patients were normal weight, 128 (34.4%) overweight, 36 (9.7%) obese, 26 (7%) underweight and 8 (2.2%) severe obese. Totally, 5426 catheter days were studied. CLABSI occurred in 63 (16.9%) patients. The incidence of CLABSI was 1,161% or 11,61 per 1000 catheterization days. Obese and severe obese patients compared to the others had significantly higher CLABSI rate (p<0.05), doctors significantly increased the number of attempts to introduce CVC (p<0.05), had a significantly longer duration of catheterization (p<0.05), had significantly more catheterization days (p<0.05), showed CLABSI on a significantly lesser day (p<0.05), had a significantly longer hospitalization in ICU (p<0.05), survived to a significantly lower percentage (p<0.05) and remained significantly more in the hospital at day 28 (p<0.05). The duration of hospitalization of patients in the ICU was 19.4±12.8 days and in the hospital 24.8±12.8 days. Of all the patients, 163 (43.8%) survived and 209 (56.2%) died.
Conclusions: The incidence of CLABSI was high. The role of obesity in the incidence of CLABSI is that obese patients are more likely to be catheterized in the femoral vein and that doctors have been unable to easily place the CVC, but it took a lot of effort and more time. The establishment and implementation of an electronic surveillance program for CLABSI will help to prevent infections by CVC. Hand hygiene and the development and adoption of care protocols in daily clinical practice for the placement and care of CVCs also play an important role. The results agree with the connection between obesity and infections.
Main subject category:
Health Sciences
Keywords:
CLABSI, Obesity, Central venous catheter, Incidence, Risk factors
Number of references:
149
