The Significant Economic Impact of CRBSIs Among Central Venous Catheter-Dependent Hemodialysis Patients

Central venous catheters (CVCs) are essential vascular access devices for hemodialysis (HD) patients. However, CVCs are associated with catheter-related bloodstream infections (CRBSIs) due to catheter hub contamination. These infections are correlated with greater hospitalizations, long-term complications, and overall costs. Researchers sought to evaluate the incremental cost of CRBSIs in HD patients with CVCs. The results were published as a poster at AMCP Nexus 2021.

In this case-control study, researchers’ 1:1 propensity score matched 55,727 HD patients (mean age 67.81 years, 44.6% female) who had an occurrence of CRBSI post CVC-insertion. Inclusion criteria was defined as CVC-dependent HD patients from 2014 to 2016 with data from one year pre- and at least one year post-index period. The researchers identified the non-CRBSI control group via an assigned-index date. Cohort differences were assessed using frequency, mean, median, chi-square, and t-tests. The investigators used adjusted generalized linear models to assess differences in all-cause inpatient hospitalization and total costs between CRBSI and non-CRBSI patients.

According to the results, approximately 29% of the study population had an occurrence of CRBSI post CVC-insertion. In the one-year post-CRBSI incidence, the researchers observed that the monthly all-cause inpatient hospitalization costs were $6,015 compared with $2,278 for matched non-CRBSI patients. Similarly, they noted, the mean monthly total costs were $10,900 vs. $6,006 in CRBSI and non-CRBSI patients, respectively.

“Results suggest that CRBSI patients incur more than double the all-cause inpatient hospitalization costs/month compared to non-CRBSI patients in the year following CRBSI incidence. Total costs for patients were also found to be 83% higher in CRBSI patients as compared to non-CRBSI patients.

Source: Rajagopalan K, et al. Incremental Cost of CRBSIs Among Central Venous Catheter-Dependent Hemodialysis Patients: A Claims-Based Assessment of USRDS-Linked Medicare Data. Poster T2. Published for AMCP Nexus 2021; Oct. 18-21, 2021, Denver, CO.