Estimating Survival Functions to Distinguish Health Care--Associated Infection Recurrence Among Hospital ICUs

• Activity Number: 648
• Type: Contributed
• Date/Time: Thursday, August 8, 2013 : 8:30 AM to 10:20 AM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Jonathan R. Edwards*+
• Companies: CDC
• Keywords: Healthcare ; Infection ; Survival Analysis

Abstract

CDC's National Healthcare Safety Network (NHSN), used by CDC and its partners for surveillance of healthcare-associated infections (HAIs), provides summary infection incidence measures to participating hospitals to help promote healthcare quality. Additional measures are needed to further distinguish HAI recurrence. In 2011, continuous reporting of central line-associated bloodstream infections (CLABSIs) began in NHSN allowing for the estimation of survival functions within hospital ICUs. Survival functions for the first CLABSI in a given month and hazard ratios among recurring CLABSIs in a year were estimated.

In 2011, there were 77,587 months of data summarizing CLABSI incidence reported to NHSN from 6,775 hospital ICUs. Hospital-level CLABSI summary incidence measures are heavily influenced by exposure volume and event rarity in CLABSI recurrence. Survival analysis was used to produce adjusted survival curves and hazard ratios to supplement existing measures. Estimating adjusted survival functions and hazard ratios will help to distinguish CLABSI recurrence among hospital ICUs and provide support to performance quality measurement.