Prognostic factors for mortality in catheter-related bloodstream ınfections among hemodialysis patients: A prospective single-center study

Abstract

Background and Objectives: Catheter-related bloodstream infection (CRBSI) is a major lifethreatening complication among patients undergoing hemodialysis (HD) through central venous catheters. This study was performed to determine mortality risk factors in HD patients with CRBSI. Materials and Methods: Data were collected prospectively from patients with CRBSI using central venous catheters as HD access between November 2022 and November 2023. A total of 60 patients were evaluated with respect to age, sex, catheter dwell time, insertion site, comorbidities, and a range of clinical findings. Demographic and clinical characteristics were compared between survivors and non-survivors. A p-value < 0.05 was considered statistically significant. Risk factors were assessed through univariate and multivariate regression analyses. Results: The median age of the patients was 63 years, and 56.9% were male. The in-hospital mortality rate among the HD patients with CRBSI was 15%. Gram-positive microorganisms were responsible for 55.6% of the cases resulting in mortality. The following factors were associated with mortality: multidrug-resistant (MDR) microorganisms, the presence of a non-tunneled catheter, concomitant pyocystitis, elevated C-reactive protein, qSOFA ≥ 2, and altered consciousness. In multivariate logistic regression, MDR microorganisms, concomitant pyocystitis, and qSOFA ≥ 2 remained significant independent predictors of mortality. Conclusions: Our findings show that the above factors may be useful in predicting mortality in HD patients with CRBSI. Awareness of these factors and prompt intervention can help reduce mortality