Effectiveness of Disinfecting Caps for Intravenous Access Points in Reducing Central Line-Associated Bloodstream Infections, Clinical Utilization, and Cost of Care During COVID-19

Figures & data

Table 1 Patient Demographics, Comorbidities, and Hospital Characteristics in the Disinfecting Cap and No-Disinfecting Cap Groups

	Disinfecting Cap (n=7423)	No-Disinfecting Cap (n=192,988)
Patient Demographics
Age; mean (SD)	60.0 (19.4)	61.2 (18.1)
n (%)
< 18	183 (2.5)	4943 (2.6)
18–35	817 (11.0)	13,357 (6.9)
36–64	2871 (38.7)	80,152 (41.5)
≥ 65	3552 (47.9)	94,536 (49.0)
Gender; n (%)
Female	3894 (52.5)	90,478 (46.9)
Male	3529 (47.5)	102,510 (53.1)
Race; n (%)
White	3776 (50.9)	133,309 (69.1)
Black	2392 (32.2)	35,308 (18.3)
Asian	13 (0.2)	4880 (2.5)
Other	1242 (16.7)	19,491 (10.1)
Patient Comorbidities
Asthma; n (%)	568 (7.7)	12,289 (6.4)
Blood Disorder^a; n (%)	3650 (49.2)	125,483 (65.0)
Myocardial Infarction; n (%)	1334 (18.0)	38,983 (20.2)
Paraplegia and Hemiplegia; n (%)	284 (3.8)	12,089 (6.3)
Renal Disease; n (%)	2106 (28.4)	79,719 (41.3)
Cancer (Primary); n (%)	929 (12.5)	31,712 (16.4)
AIDS/HIV; n (%)	49 (0.7)	1431 (0.7)
Congestive Heart Failure; n (%)	2440 (32.9)	73,944 (38.3)
Peripheral Vascular Disease; n (%)	1505 (20.3)	41,250 (21.4)
Cerebrovascular Disease; n (%)	1051 (14.2)	29,831 (15.5)
Dementia; n (%)	848 (11.4)	17,658 (9.1)
Chronic Pulmonary Disease; n (%)	2750 (37.0)	64,369 (33.4)
Rheumatic Disease; n (%)	400 (5.4)	9364 (4.9)
Peptic Ulcer Disease; n (%)	309 (4.2)	10,458 (5.4)
COPD; n (%)	1495 (20.1)	34,643 (18.0)
Diabetes; n (%)	3144 (42.4)	90,495 (46.9)
SIRS; n (%)	448 (6.0)	47,171 (24.4)
Hypertension; n (%)	2721 (36.7)	56,797 (29.4)
Liver Disease; n (%)	902 (12.2)	30,036 (15.6)
Obesity; n (%)	1420 (19.1)	50,308 (26.1)
Alcohol-Related Disorder; n (%)	533 (7.2)	13,553 (7.0)
Used of Cocaine; n (%)	197 (2.7)	2558 (1.3)
Nicotine Dependence; n (%)	1594 (21.5)	36,432 (18.9)
ICU Admission; n (%)	1423 (19.2)	12,364 (6.4)
Metastatic Carcinoma; n (%)	357 (4.8)	13,150 (6.8)
CCI; mean (SD)	3.8 (3.4)	4.6 (3.4)
Facility Characteristics
Provider Location; n (%)
Urban	4366 (58.8)	170,499 (88.3)
Rural	3057 (41.2)	22,489 (11.7)
Teaching Hospital; n (%)	0 (0.0)	100,239 (51.9)
Number of Beds; n (%)
< 400	4392 (59.2)	89,333 (46.3)
≥ 400	3031 (40.8)	103,655 (53.7)
Cost Type; n (%)
Procedural	65 (0.9)	138,081 (71.5)
RCC	7358 (99.1)	54,907 (28.5)
Provider Region; n (%)
Midwest	0 (0.0)	37,025 (19.2)
Northeast	65 (0.9)	22,079 (11.4)
South	7358 (99.1)	96,532 (50.0)
West	0 (0.0)	37,352 (19.4)

Notes: ^aBlood Disorder: diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (medical classification list by the World Health Organization).

Abbreviations: COPD, chronic obstructive pulmonary disease; AIDS/HIV, acquired immunodeficiency syndrome/human immunodeficiency virus; SIRS, systemic inflammatory response syndrome; ICU, intensive care unit; CCI, Charlson Comorbidity Index; RCC, ratio of costs-to-charges (to pay hospitals for services exempt from DRG payment); SD, standard deviation.

Table 2 Comparison of Endpoints Between the Disinfecting Cap and No-Disinfecting Cap Groups

	Disinfecting Cap	No-Disinfecting Cap	Statistic Reported	Statistic	P value
CLABSI Incidence; %	0.30%	1.11%	Odds Ratio (95% CI)	0.27 (0.12, 0.60)	0.0013
Length of Stay (Days); Mean	9.20	9.71	Odds Ratio (95% CI)	0.95 (0.91, 0.99)	0.0169
Cost ($); Mean	35,604	42,307	Difference in Means (95% CI)	−6703 (−11,511, −1895)	0.0063

Abbreviations: CLABSI, central line-associated bloodstream infection; CI, confidence interval.

Figure 1 Central line-associated bloodstream infection incidence comparison.

Figure 2 Hospital length of stay comparison (days).

Figure 3 Hospitalization cost comparison (US dollars).