Performance characteristics and associated outcomes for an automated surveillance tool for bloodstream infection - 02/05/16
, Xiaowu Sun, PhD b, Ying P. Tabak, PhD b, Richard S. Johannes, MD b, Ari Robicsek, MD c, d, eAbstract |
Background |
The objective of this study was to evaluate performance metrics and associated patient outcomes of an automated surveillance system, the blood Nosocomial Infection Marker (NIM).
Methods |
We reviewed records of 237 patients with and 36,927 patients without blood NIM using the National Healthcare Safety Network (NHSN) definition for laboratory-confirmed bloodstream infection (BSI) as the gold standard. We matched cases with noncases by propensity score and estimated attributable mortality and cost of NHSN-reportable central line–associated bloodstream infections (CLABSIs) and non–NHSN-reportable BSIs.
Results |
For patients with central lines (CL), the blood NIM had 73.2% positive predictive value (PPV), 99.9% negative predictive value (NPV), 89.2% sensitivity, and 99.7% specificity. For all patients regardless of CL status, the blood NIM had 53.6% PPV, 99.9% NPV, 84.0% sensitivity, and 99.9% specificity. For CLABSI cases compared with noncases, mortality was 17.5% versus 9.4% (P = .098), and median charge was $143,935 (interquartile range [IQR], $89,794-$257,447) versus $115,267 (IQR, $74,937-$173,053) (P < .01). For non–NHSN-reportable BSI cases compared with noncases, mortality was 23.6% versus 6.7% (P < .0001), and median charge was $86,927 (IQR, $54,728-$156,669) versus $62,929 (IQR, $36,743-$115,693) (P < .0001).
Conclusions |
The NIM is an effective screening tool for BSI. Both NHSN-reportable and nonreportable BSI cases were associated with increased mortality and cost.
Le texte complet de cet article est disponible en PDF.Key Words : Electronic surveillance, central line–associated bloodstream infection, outcomes, electronic health record
Plan
| Funding/Support: Supported by CareFusion. |
|
| Conflicts of Interest: XS, YPT, and RSJ are employees of CareFusion-BD. JPR and AR received funding from CareFusion to carry out this project. |
Vol 44 - N° 5
P. 567-571 - mai 2016 Retour au numéro
Article précédent
- An investigation of an outbreak of hepatitis C virus infections in a low-resourced hemodialysis unit in Vietnam
- Cuong Minh Duong, Mary-Louise McLaws
- Influence of high body mass index on mortality and infectious outcomes in patients who underwent open gastrointestinal surgery: A meta-analysis
- Yunhong Liu, Yanyan Dong, Xiaohui Wu, Hongbo Chen, Shuhui Wang
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?