Abstract: FR-PO547
Hospital Admissions for Bloodstream Infections Acquired during Outpatient Hemodialysis through a Central Venous Catheter (HD-CVC): Patient Population and Selected Outcomes
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Crandon, Jared L., CorMedix Inc., Berkley Heights, New Jersey, United States
- Weir, Sharada, Health economist in private practice, Austin, Texas, United States
- Michaud, Mary P., CorMedix Inc., Berkley Heights, New Jersey, United States
- Sullivan, Peter, CorMedix Inc., Berkley Heights, New Jersey, United States
- Hurlburt, Liz, CorMedix Inc., Berkley Heights, New Jersey, United States
Background
HD-CVC patients are at an increased risk for catheter related bloodstream infections. The purpose of this study was to characterize the demographics, clinical baseline characteristics, and selected outcomes for HD-CVC patients who were hospitalized for treatment of bloodstream infections (BSIs).
Methods
All admissions of adult HD-CVC patients in the Premier Healthcare Database with discharge dates during 2020-2022 were retrospectively evaluated. The first hospital admission in which each patient presented with a BSI was included in the final analysis. BSIs were identified by ICD-10 codes and blood culture collection dates. A BSI was deemed present-on-admission (BSI-POA) if the blood culture date was <3 calendar days after admission. Descriptive analyses included baseline demographics, clinical characteristics, and outcomes. Hospital costs were estimated based on patient level data reported from each hospital.
Results
Admissions were identified for 91,448 unique patients; 25% (N=22,902) presented with a BSI. Patients were 58.2% white, 27.1% black, and 56.6% male. Most (59.3%) were aged ≥60 years and more than three-quarters resided in census tracts above the median ranking on CDC’s Social Vulnerability Index, with 47.0% in the most vulnerable quartile of neighborhoods nationwide. Patients had many comorbidities at baseline with 87.8% having ≥3 Charlson comorbid conditions and 42.6% with ≥6. Median length-of-stay was 16 days, with 53.8% of admissions including time in the ICU (median: 8d). 26.8% of patients were readmitted within 90 days, 46.3% were BSI-related. All-cause, in-hospital mortality was 10.3%, with a further 4.7% expiring within 90d of discharge. The median total admission cost was $157K. Of which, a median cost of $65K was allocated to ICU care.
Conclusion
We described the characteristics of HD-CVC patients who presented to hospitals with BSIs. These data highlight the complexity and social vulnerability of these patients and the extensive healthcare utilization resultant from these infections. Moreover, care of these patients was associated with considerable healthcare costs and 1-in-10 patients died whilst inpatient. Future studies should characterize risk factors and evaluate potential prevention strategies for this high-risk population.
Funding
- Commercial Support – CorMedix Inc.