title: On the role of length of stay in healthcare-associated bloodstream infection.
abstract: METHODS
  We conducted a retrospective cohort study to examine the role played by length of hospital stay in the risk of healthcare-associated bloodstream infection (BSI), independent of demographic and clinical risk factors for BSI.
  
  
  METHODS
  We employed data from 113,893 admissions from inpatients discharged between 2006 and 2008.
  
  
  METHODS
  Large tertiary healthcare center in New York City.
  
  
  METHODS
  We estimated the crude and adjusted hazard of BSI by conducting logistic regression using a person-day data structure. The covariates included in the fully adjusted model included age, sex, Charlson score of comorbidity, renal failure, and malignancy as static variables and central venous catheterization, mechanical ventilation, and intensive care unit stay as time-varying variables.
  
  
  RESULTS
  In the crude model, we observed a nonlinear increasing hazard of BSI with increasing hospital stay. This trend was reduced to a constant hazard when fully adjusted for demographic and clinical risk factors for BSI.
  
  
  CONCLUSIONS
  The association between longer length of hospital stay and increased risk of infection can largely be explained by the increased duration of stay among those who have underlying morbidity and require invasive procedures. We should take caution in attributing the association between length of stay and BSI to a direct negative impact of the healthcare environment.
authors.affiliation: Columbia University School of Nursing, New York, New York, USA. christie.jeon@gmail.com
authors.forename: Christie Y
authors.initials: CY
authors.lastname: Jeon
authors.forename: Matthew
authors.initials: M
authors.lastname: Neidell
authors.forename: Haomiao
authors.initials: H
authors.lastname: Jia
authors.forename: Matt
authors.initials: M
authors.lastname: Sinisi
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology*; D018709:Statistics, Nonparametric; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult