SIR 2024
General IR
Ran Jing, MD
Resident, Vascular and Interventional Radiology
University of Michigan
Financial relationships: Full list of relationships is listed on the CME information page.
Raja Issa, NP
Clinical Nursing Director (Interventional Radiology) and Adjunct Clinical Instructor in Nursing, Sch
University of Michigan
Disclosure information not submitted.
Hassan Anbari, MD
Assistant Clinical Professor
Vascular and Interventional Radiology/University of Michigan
Financial relationships: Full list of relationships is listed on the CME information page.
Baljendra Kapoor, MD
Vascular and Interventional Radiology
Financial relationships: Full list of relationships is listed on the CME information page.
Jared Christensen, MD
Clinical Assistant Professor
University of Michigan
Disclosure information not submitted.
To retrospectively review the rate of Central Line-Associated Bloodstream Infections (CLABSIs) in central lines performed by the interventional radiology (IR) division at a single center and to identify potential associated causes of CLABSI in these patients.
Materials and Methods:
A comprehensive retrospective analysis encompassing all central line placements at our institution spanning from 2021 to 2023 was performed. CLABSI cases were meticulously identified in accordance with the surveillance criteria outlined by the National Healthcare Safety Network, as established by the Centers for Disease Control and Prevention. The analysis specifically categorized CLABSI cases as insertion-related if they occurred within a 7-day timeframe following central line insertion. The acquired data was further stratified, distinguishing between adult and pediatric patients, and analyzed based on criteria including central line type, insertion site, procedural location, and the role of the proceduralist (e.g., trainee, faculty member, or advanced practice provider).
Results:
A total of 6033 central lines were inserted by the IR service in the two-year period. The overall insertion-related CLABSI rate was 2.3 per 1000 insertions. On average, CLABSI was identified 4.4 days post-insertion, with a median of 4 days after insertion. A higher CLABSI incidence was observed among pediatric patients (4.6 vs. 1.2 per 1000 insertions), and in patients undergoing central line insertion at the bedside (5.1 vs. 1.9 per 1000 insertions). Our analysis also identified improvement opportunities in hand hygiene, chlorhexidine use, sterile techniques, and communication with referring providers to prevent CLABSI and enhance care quality.
Conclusion:
Previous research and Evidence Based Practice initiatives have predominantly focused on post-insertion CLABSI in intensive care unit (ICU) settings, primarily performed by surgical and ICU teams. Our analysis demonstrates a low but clinically important rate of CLABSI, which is highest in pediatric patients and in patients undergoing line placement at the bedside, and lowest in patients who undergo their line placement in the IR suite. This retrospective study endorses the need for interventional radiology practitioners to prevent CLABSI by following recommended CLABSI prevention practices as well as to establish a routine monitoring system. These findings will guide the development of a robust quality improvement plan, aligned with current infection prevention guidelines, with the aim of reducing CLABSIs in IR-performed cases.