Central-Line-Associated Bloodstream Infections (CLABSIs) Incidence and the Role of Obesity: A Prospective, Observational Study in Greece.

INTRODUCTION: Although central venous catheters (CVCs) provide reliable vascular access, there are several risks linked with their use, with the rates of central-line-associated bloodstream infections (CLABSIs) being the most important ones. CLABSIs have a big impact on mortality rates and health care costs. The aim of this study was to investigate the incidence of obesity in the development of central venous catheter infections. MATERIAL AND METHOD: This is a prospective, observational study. The data were collected in the ICUs of three major hospitals in Greece, over a period of 18 months. Totally, 744 patients were included in the study. RESULTS: The study included 744 ICU patients aged 63.6 ± 16.6 years. The Apache II score and MODS score of patients were 23.3 ± 6.9 and 7.5 ± 3.8, respectively. Totally, 5.426 catheter-days were included in the study. Among the 722 CVCs, 178 (24.7%) were CLABSIs. The incidence rate of CVC-associated CLABSI was 22.48 infections per 1000 catheter-days. CLABSI was significantly predicted by the BMI (p = 0.001), by the diabetes mellitus as comorbidity (p = 0.013), by the doctors' experience (p = 0.001), by the type of CVC (p = 0.001) and CVC site (p = 0.001), by the number of efforts for CVC insertion (p = 0.009), by the catheterization's duration (p = 0.001) and by the MODS score (p = 0.001). CONCLUSIONS: Better staff training focused on care bundles preventing infections, better medical training focused on less efforts for CVC insertion, and the use of Ultrasounds during the CVC insertion may be the main factors that can lead to lower CLABSI rates in obese patients. Further research relating CLABSI rates in ICU patients and obesity is needed.

Compliance of Patients with Acute Coronary Syndrome with Treatment Following Their Hospitalization from the Cardiac Coronary Unit.

BACKGROUND: Low compliance rates with medication after an acute coronary syndrome (ACS) is a serious public health problem with adverse socioeconomic implications for both patients and their families as well as for health systems in general. The aims of the study are to measure the levels of compliance with medication in the treatment of patients who suffered from ACS and to investigate the factors contributing to the noncompliance. METHODS: The sample consisted of 100 patients hospitalized in the coronary care unit (CCU) of a general hospital. The compliance of patients with treatment, which was measured with the GR-SMAQ and ARMS scales, was measured at 3, 6, and 12 months after their hospitalization. The t-test and control X2 were used, and the value of statistical significance was set to 0.05. RESULTS: According to the GR-SMAQ and ARMS scales, compliance of patients at 3, 6, and 12 months after hospitalization is low (58%, 70%, 32% with ARMS scale and 54%, 58%, 38% with GR-SMAQ scale, respectively). Patients who were readmitted to CCU had 68.9% less chances of showing compliance, and patients who had normal levels of systolic blood pressure were 3.5 times more likely to adhere to their treatment. No correlation between compliance and social demographic data, such as gender, age, level of study, and family and occupational status, was found (p > 0.05). CONCLUSION: Compliance of patients who suffered from ACS is at low level. There is a need for closed monitoring and use of wearable devices in order to improve the compliance rates.