1497: Site Selection and Clabsi Incidence in an Icu of a Tertiary Hospital in the Philippines

Introduction: This study explored the impact of central venous catheter (CVC) insertion site selection on the incidence of central line-associated bloodstream infections (CLABSIs) in critically ill patients admitted to the intensive care units (ICUs) of a tertiary hospital in the Philippines. While CVCs are vital for administering medications, fluids, and renal replacement therapies, they are associated with complications such as CLABSI, a leading cause of ICU morbidity, mortality, and prolonged hospitalization. Methods: A retrospective cohort study was conducted at Asian Hospital and Medical Center from January 1, 2019 to December 31, 2023. Adult patients (≥19 years old) admitted to any of the hospital’s ICUs who underwent CVC insertion during their stay were included. Patients were categorized into CLABSI and non-CLABSI groups. Data were collected from the Cardiovascular, Medical-Surgical, and Neurology ICUs. Statistical tools used included chi-square, Fisher’s exact test, Welch’s t-test, and logistic regression to evaluate associations between insertion site, patient outcomes, and risk factors. Results: Among 257 patients reviewed, 40 developed CLABSI, corresponding to an overall incidence of 15.56%. The internal jugular vein (IJV) was the most frequently used site, followed by the subclavian and femoral veins. Although variation in infection rates was noted by site, no statistically significant association between insertion site and CLABSI was observed (p = 0.593). However, CLABSI was significantly associated with worse clinical outcomes, including higher mortality (75% vs. 36.87%) and longer ICU stay (mean 29.65 vs. 13.20 days), with both differences reaching statistical significance (p < 0.001). Logistic regression revealed that patient-related risk factors such as immunosuppression, malnutrition, or prolonged hospitalization were significantly associated with CLABSI (p = 0.006), whereas insertion site, age, and sex were not. Conclusions: In conclusion, while site selection remains a relevant procedural decision, it may not independently determine CLABSI risk when standard infection control measures are applied. These findings highlight the importance of focusing on infection prevention strategies and risk factor modification to reduce CLABSI in critically ill patients.