Ryder Marcia, Battle Jason
Ryder Science, Brentwood, TN, USA.
ICU Medical, San Clemente, CA, USA.
J Vasc Access. 2025 Jul;26(4):1194-1205. doi: 10.1177/11297298241261951. Epub 2024 Aug 3.
To compare relative risk (RR) of central line-associated bloodstream infection (CLABSI) between hospitals using Clave needleless connector technologies (NCT) and comparator hospitals using non-Clave NCT. And, to estimate avoided CLABSIs, mortality, and cost savings.
Needleless connectors, while protective against needlestick injury, have long been implicated as a potential risk for CLABSI. Significant RR reduction of CLABSI among the many NCT has not been clinically demonstrated.
The U.S. Healthcare-Associated Infections database was accessed for CLABSI data for calendar year 2019 via the Centers for Medicare and Medicaid Services website. This dataset was merged with the Clave NCT manufacturer's 2019 database to identify hospitals purchasing Clave NCT (MicroClave™, NanoClave™, Clave Neutron™, Clave™, Microclave™ Clear) and non-Clave NCT comparator hospitals. Sub-analysis of Clave NCT hospitals included: (1) Clave NCT mixed-use and (2) Clave high-volume use hospitals. The standardized infection ratio (SIR) was generated to estimate CLABSI RR after adjusting for intern/resident-to-bed-ratio (IRB), care location, and hospital demographics. Using the RR, avoided CLABSIs, mortality, and cost savings were calculated.
A total of 2987 eligible hospitals (1288 Clave NCT, 1699 non-Clave NCT) with 17,452,575 central line-days were evaluated. All three Clave NCT hospital groups showed a statistically significant reduction in RR compared to the non-Clave NCT hospitals. The RR in Clave NCT hospitals was 0.93, a 7% decrease in CLABSI risk ( = 0.02). In the Clave NCT subgroups, mixed-use hospitals RR was 0.93, a 7% reduction ( = 0.04), while the Clave NCT high-volume hospitals experienced a 19% reduction, RR 0.81 ( = 0.04). An estimated 563 CLABSIs and 84 related deaths were avoided with use of Clave NCT and $27,095,231 in cost savings.
The use of the Clave NCT, in and of itself, is an effective risk reduction strategy for CLABSI prevention, reduced mortality, and substantial cost savings.
比较使用Clave无针连接技术（NCT）的医院与使用非Clave NCT的对照医院发生中心静脉导管相关血流感染（CLABSI）的相对风险（RR）。并且，估算避免的CLABSI、死亡率和成本节约情况。
无针连接器虽然能预防针刺伤，但长期以来一直被认为是CLABSI的潜在风险。许多NCT中CLABSI的RR显著降低尚未得到临床证实。
通过医疗保险和医疗补助服务中心网站访问美国医疗相关感染数据库，获取2019日历年的CLABSI数据。该数据集与Clave NCT制造商的2019年数据库合并，以识别购买Clave NCT（MicroClave™、NanoClave™、Clave Neutron™、Clave™、Microclave™ Clear）的医院和非Clave NCT对照医院。对Clave NCT医院的亚分析包括：（1）Clave NCT混合使用医院和（2）Clave高使用量医院。在调整实习医生/住院医生与床位比例（IRB）、护理地点和医院人口统计学因素后，生成标准化感染率（SIR）以估算CLABSI RR。使用RR计算避免的CLABSI、死亡率和成本节约情况。
共评估了2987家符合条件的医院（1288家Clave NCT医院，1699家非Clave NCT医院），中心静脉导管留置天数为17452575天。与非Clave NCT医院相比，所有三个Clave NCT医院组的RR均有统计学显著降低。Clave NCT医院的RR为0.93，CLABSI风险降低了7%（P = 0.02）。在Clave NCT亚组中，混合使用医院的RR为0.93，降低了7%（P = 0.04），而Clave NCT高使用量医院的RR降低了19%，为0.81（P = 0.04）。使用Clave NCT估计可避免563例CLABSI和84例相关死亡，并节省成本27095231美元。
使用Clave NCT本身就是一种有效的降低风险策略，可预防CLABSI、降低死亡率并大幅节省成本。
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