Comparative Effectiveness of 2 Chlorhexidine Gluconate-Containing Dressings in Reducing Central Line-Associated Bloodstream Infections, Hospital Stay, and Costs

• Published in: Inquiry (Chicago) Vol. 60; p. 469580231214751
• Main Authors: Hou, Yuefeng, Griffin, Leah, Bernatchez, Stéphanie F., Hommes, Joseph, Kärpänen, Tarja, Palka-Santini, Maria
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2023; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Anti-Infective Agents, Local - therapeutic use; Antimicrobial agents; Bandages; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - methods; Catheters; Comparative Effectiveness Research; Costs; Dermatitis, Contact - etiology; Disease prevention; Health care industry; Health services; Hospitals; Humans; Intensive care; Length of Stay; Nosocomial infections; Original Research; Patients; Retrospective Studies; Sepsis - etiology; Sepsis - prevention & control; Skin; United States > US; Premier Healthcare Database; comparative study; real world evidence; outcome research; inpatient
• ISSN: 0046-9580; 1945-7243
• DOI: 10.1177/00469580231214751

Chlorhexidine gluconate (CHG)-containing dressings are recommended to prevent central line associated bloodstream infections (CLABSIs) and other catheter-related infections. This study compared the effect of 2 CHG dressings on CLABSI, cost of care, and contact dermatitis. A retrospective analysis was conducted using the Premier Healthcare Database of hospitalized patients (n = 53 149) with central venous catheters (CVCs) and receiving either a transparent CHG gel dressing (n = 14 488) or an opaque CHG sponge dressing (n = 38 661) between January 2019 and September 2020. Two cohorts (n = 14 488 each), CHG-Gel and CHG-Sponge, were matched 1:1 using a propensity score method on 33 patient and facility characteristics. CLABSI and contact dermatitis rates, hospital length of stay (LOS), and hospitalization costs were compared using mixed-effect multiple regression. This approach effectively controlled for random clustering effects across hospitals and patients’ Diagnosis-Related Group (DRG) classifications. CHG gel dressings were associated with a 41% decrease in CLABSI rates (P = .0008) compared to CHG sponge dressings (0.35%vs 0.60%). A 0.4-day shorter LOS (9.53vs 9.90 days, P = .0001) and a cost saving of $3576 per hospital stay ($40 197 vs $43 774, P = .0179) was observed with CHG gel dressing use. There was no statistically significant difference in contact dermatitis rates (P = .7854) between the CHG-Gel and CHG-Sponge cohorts. The findings of this study suggest that the use of CHG gel dressings may be more effective in reducing the risk of CLABSIs and associated clinical costs compared to CHG sponge dressings in hospitalized patients. Moreover, there appears to be no significant discrepancy in contact dermatitis rates between CHG gel and CHG sponge dressings. Healthcare providers may consider using CHG gel dressings as a standard practice for patients with CVCs to reduce the risk of infections and improve patient outcomes.