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Racial and ethnic disparities in central line-associated bloodstream infections (CLABSI) in hospitalized patients: a risk-adjusted analysis
Published online by Cambridge University Press: 18 February 2025
Abstract
Objective:
To compare the risk and exposure-adjusted central line-associated bloodstream infection (CLABSI) rates between racial and ethnic groups.
Design:
Retrospective cohort study.
Setting:
15 network hospitals in Illinois and Michigan (Part of OSF HealthCare).
Patients:
Patients of all age groups who had a central line inserted and removed during the same hospitalization between 01/2018 and 06/2023.
Methods:
CLABSI rates/1000 Central line days of the four major racial and ethnic categories (Hispanic, non-Hispanic White [NHW], non-Hispanic Black [NHB], and non-Hispanic others) were analyzed by generalized Poisson regression. Confounding variables included in the regression model based on a directed acyclic graph and included age group, insurance class, language, ICU admission, diagnostic cohorts (obesity, diabetes, dialysis, cancer, neutropenia), and line usage (blood products, chemotherapy, total parenteral nutrition).
Results:
27,674 central lines (244,889 catheter days) on 23,133 unique patients (median age 64 years, 8% pediatric patients) were included in the analysis. Overall, the CLABSI rate was 1.070/1000 Central line days. 76% of the study population was NHW, 17% NHB, and 4% Hispanic. After adjusting for confounding variables, Hispanic patients had higher CLABSI rates than NHW (IRR 1.89, 95% CI 1.15–3.10, P = .013). No significant difference was observed in the CLABSI rates between NHW and NHB patients.
Conclusion:
Disparities in hospital-associated conditions persist even after controlling for patient-level risk factors and exposures, with Hispanic patients at the highest risk.
- Type
- Original Article
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America
Footnotes
Previous Submission: The abstract from this data has been accepted for presentation at the Society of Critical Care Medicine National Congress, which will be held in February 2025. It will be published in the Critical Care Medicine supplement for Congress abstracts.
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