669. Ethanol Lock Therapy: Patient Outcomes in Home Infusion
Session: Poster Abstract Session: Preventing Catheter Associated Infections
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • 669 Ethanol Lock Therapy Patient Outcomes in Home Infusion.pdf (305.7 kB)
  • Background: This study evaluated the outcomes of ethanol lock therapy (ELT), including hospitalization rate, infection rate, and salvaging catheter lines associated with central-line associated bloodstream infections (CLABSI) in patients receiving ELT from a national home infusion provider.

    Methods: This retrospective review of ELT captured and analyzed specific data elements in the electronic medical record of patients identified during the study period. Markers of clinical outcomes included catheter infections, hospitalizations, and adverse events. All patient-specific identifiers were deleted from the data analysis and reports.  Seventy-nine patients received ELT between June 2009 and September 2010, representing 20,475 catheter-days.  In this patient group, on-ELT catheter-days was 14,774; off-ELT catheter-days was 5,701.  Most (N=72) patients received 70% ethanol.  ELT regimens ranged from every 12 hours to twice weekly, with most patients using ELT daily (N=53).  The ELT time instilled in the catheter ranged from 0.5 to 24 hours.  The Byar test for rate ratio was performed to determine the significance of these results.

    Results: Six central venous catheters (CVC) were removed and replaced while on ELT.  The rate of on-ELT CVC replacement was 0.41 per 1000 catheter-days.  There were 14 off-ELT CVC replacements, for a CVC replacement rate of 2.46 per 1000 catheter-days.  Rate ratio 0.1654 (confidence interval (CI) 0.06356-0.4303).  There were 19 on-ELT hospitalizations in 14 patients, for an on-ELT hospitalization rate of 1.29 per 1000 catheter-days.  Eleven off-ELT hospitalizations, for a hospitalization rate of 1.93 per 1000 catheter-days. Rate ratio 0.6665 (CI 0.3172-1.401).  Four on-ELT CVC infections were reported, for an infection rate of 0.27 per 1000 catheter-days.  Six off-ELT CVC infections were reported, for an infection rate of 1.05 per 1000 catheter-days.  Rate ratio 0.2573 (CI 0.726-0.9115). 

    Conclusion: In this patient sample, the rates of catheter replacement, infection, and hospitalization were lower on-ELT than off-ELT.  This was statistically significant for infections and CVC replacements.  This demonstrated the efficacy of ELT for this population of home infusion patients at risk for CLABSI. 


    Subject Category: A. Antimicrobial agents and Resistance

    Laura Ustaszewski, PharmD1, Caryn Bing, MS, RPH, FASHP2, Kevin Ross, RN, BSN3 and Cindy Kunzendorf, RPh, MBA1, (1)Critical Care Systems, Inc, Elmhurst, IL, (2)Clinical Services, Critical Care Systems, Inc., Las Vegas, NV, (3)Nurse Consultant, Bartonville, TX

    Disclosures:

    L. Ustaszewski, None

    C. Bing, None

    K. Ross, None

    C. Kunzendorf, None

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