Examining the association between chest tube-related factors and the risk of developing healthcare-associated infections in the ICU of a community hospital: A retrospective case-control study

Summary 

Objectives

The study examined the association between chest tube-related factors and the risk for developing healthcare-associated infections (HAI).

Research methodology

A case-control retrospective chart review was performed on 120 intensive care patients. Eligible patients were 18 years of age or older, had been in the intensive care unit (ICU) for 48h or more, and had one or more chest tubes.

Setting

A 20-bed medical–surgical intensive care unit (ICU) of a community hospital in south-western Ontario, Canada.

Main outcome measures

Documented diagnosis of hospital-acquired pneumonia or bloodstream infection.

Results

The variable chest tube days was the only chest tube-related factor that was independently associated with HAI (OR=5.78; p=0.013). Mechanical ventilation (OR=4.88; p=0.002) and outcome length of stay (OR=0.72; p≤0.001) were also independently associated with HAI.

Conclusions

The risk of infection among patients with chest tubes increases as the number of chest tube days increases. Infection is likely to happen early during admission, which necessitates stringent adherence to infection control strategies, especially during that time frame.

Keywords: Chest tube, Thoracostomy, Nosocomial infection, Pneumonia, Blood stream infection