Phân tích gánh nặng nhiễm khuẩn huyết liên quan đến catheter trung tâm và các yếu tố liên quan của người bệnh tại các Khoa Hồi sức, Bệnh viện Đại học Y Dược TPHCM từ năm 2017 đến năm 2022=Analysis of the burden of central line-associated bloodstream infections and related factors in patients in the Intensive Care Units of University Medical Center Ho Chi Minh City from 2017 to 2022

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Minh Tuấn Huỳnh, Thị Yến Nhi Lê, Vũ Hoàng Yến Nguyễn, Thị Lan Phạm, Thị Trường Ngân Phạm, Trí Kiên Trần, Thị Thoa Trịnh

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.116-124

Bộ sưu tập: Metadata

ID: 478199

Thêm vào giỏ

To determine the incidence of CLABSI, treatment costs, hospital stay duration, mortality rates, and factors associated with CLABSI at the University Medical Center HCMC. Method: A retrospective cross-sectional study was conducted on 2,233 patients over 18 years old with central venous catheters (CVC) in the intensive care units of UMC HCMC from 2017 to 2022. Data were collected from electronic medical records, including background information, diagnosis, laboratory tests, procedures/surgeries, treatment outcomes, and direct medical costs. Results: Among the 2,233 patients with CVCs, 16.9% (378/2,233) developed bloodstream infections (BSIs), with CLABSI accounting for 66.7% (252/378). The incidence of CLABSI was 6.9 per 1,000 CVC-days, and the CVC utilization rate was 65%. Risk factors included male gender, age ≥ 60, CVC placement location, and duration of CVC use. The rate of CLABSI in femoral veins was 10.3 times higher than in subclavian veins (PR=10.3
95% CI 6.2– 17.2). CVC retention for 14–28 days increased the risk of CLABSI by 1.8 times (PR=1.8
95% CI 1.3–2.4), and retention for more than 28 days raised it by 2.4 times (PR=2.4
95% CI 1.8–3.2). Patients with CLABSI had a threefold higher risk of mortality, stayed in the hospital for more than 22 days, and incurred an average medical cost of 476.1 million VND, which was 183.1 million VND higher than the non-CLABSI group. Gramnegative bacteria, primarily Klebsiella pneumoniae (31.2%) and Acinetobacter baumannii (12.6%), were the main causative agents. Conclusion: CLABSI increases healthcare costs, hospital stay duration, and mortality rates. Risk factors include male gender, age ≥ 60, femoral CVC placement, and prolonged CVC use. Gram-negative bacteria are the primary cause of bloodstream infections.Xác định tỷ suất mắc CLABSI, chi phí điều trị, thời gian nằm viện, tỷ lệ tử vong và yếu tố liên quan đến CLABSI tại Bệnh viện Đại học Y Dược TPHCM. Phương pháp: Mô tả cắt ngang hồi cứu trên 2.233 người bệnh (NB) ≥ 18 tuổi có đặt CVC tại các khoa hồi sức từ năm 2017-2022. Dữ liệu được thu thập từ hồ sơ, bao gồm thông tin nền, xét nghiệm, thủ thuật và chi phí y tế. Kết quả: Trong 2.233 NB có đặt CVC, 16,9% (378/2.233) mắc nhiễm khuẩn huyết (NKH), trong đó CLABSI chiếm 66,7% (252/378). Tỷ suất mắc CLABSI là 6,9/1.000 CVC-ngày và tỷ lệ sử dụng CVC là 65%. Yếu tố nguy cơ bao gồm giới nam, ≥ 60 tuổi, vị trí và thời gian lưu CVC. Tỷ lệ CLABSI ở tĩnh mạch đùi cao gấp 10,3 lần so với dưới đòn (PR=10,3
KTC 95% 6,2–17,2). Thời gian lưu CVC từ 14– 28 ngày tăng nguy cơ CLABSI gấp 1,8 lần (PR=1,8
KTC 95% 1,3–2,4), và trên 28 ngày tăng gấp 2,4 lần (PR=2,4
KTC 95% 1,8 –3,2). NB mắc CLABSI có nguy cơ tử vong gấp 3 lần, nằm viện hơn 22 ngày và chi phí y tế trung bình là 476,1 triệu VND, cao hơn 183,1 triệu VND so với nhóm không mắc. Vi khuẩn Gram âm, chủ yếu Klebsiella pneumoniae (31,2%) và Acinetobacter baumannii (12,6%), là nguyên nhân chính. Kết luận: CLABSI làm tăng chi phí, thời gian nằm viện và tỷ lệ tử vong. Các yếu tố nguy cơ như giới nam, ≥ 60 tuổi, đặt CVC ở tĩnh mạch đùi và lưu CVC kéo dài. Vi khuẩn Gram âm là nguyên nhân chính gây NKH.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR