Impact of catheter-related bloodstream infections on the mortality of critically ill patients: a meta-analysis.
OBJECTIVE
There is controversy on whether catheter-related bloodstream infections (CR-BSI) affect the mortality of critically ill patients.


METHODS
Meta-analysis of comparative studies that reported on mortality of intensive care unit (ICU) adult patients with and without CR-BSI.


METHODS
PubMed, Current Contents, and reference lists of retrieved publications were searched with no language or time restrictions. Heterogeneity was assessed by means of I-statistic and chi-square test. Publication bias was detected by the funnel plot method using Egger's test. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated by implementing both the Mantel-Haenszel fixed effect and the DerSimonian-Laird random effects model.


RESULTS
Eight studies, involving 2,540 ICU patients, were included. Heterogeneity was detected (I = 0.67, 95% CI 0.32-0.85, p = 0.003). Publication bias was not found (Egger's test, p = 0.28). All-cause in-hospital mortality was higher in ICU patients with CR-BSI than in those without CR-BSI (fixed effect model: OR = 1.81, 95% CI 1.44-2.28; random effects model: OR = 1.96, 95% CI 1.25-3.09). This was also the case for the subgroup analysis of the studies that were matched for severity of illness (fixed effect model: OR = 1.65, 95% CI 1.28-2.13; random effects model: OR = 1.70, 95% CI 1.00-2.90).


CONCLUSIONS
Presence, as opposed to absence, of CR-BSI is associated with higher mortality in critically ill adult patients. This finding seems to justify and may enhance efforts to prevent CR-BSI in such patients.
Siempos
Ilias I
II
Critical Care Department, "Attikon" University Hospital, Athens, Greece. isiempos@yahoo.com
Kopterides
Petros
P
Tsangaris
Iraklis
I
Dimopoulou
Ioanna
I
Armaganidis
Apostolos E
AE
D000328:Adult; D016470:Bacteremia / Q000401:mortality*; D055499:Catheter-Related Infections / Q000401:mortality*; D003422:Critical Care / Q000706:statistics & numerical data; D016638:Critical Illness / Q000401:mortality*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D012307:Risk Factors