Racial and ethnic disparities in central line-associated bloodstream infections (CLABSI) in hospitalized patients: a risk-adjusted analysis.

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.