Validation of Fuzzy Sets in an Automated Detection System for Intensive-Care-Unit-Acquired Central-Venous-Catheter-Related Infections

Central venous catheters play an important role in patient care in intensive care units (ICUs), but their use comes at the risk of catheter-related infections (CRIs). Electronic surveillance systems can detect CRIs more accurately than manual surveillance, but these systems often omit patients that do not exhibit all infection signs to their full degree, the so-called borderline group. By extending an electronic surveillance system with fuzzy constructs, the borderline group can be identified. In this study, we examined the size of the borderline group for systemic CRIs (CRI2) by calculating the frequency of fuzzy values for CRI2 and related infection parameters in patient data involving ten ICUs (75 beds) over one year. We also validated the expert-defined fuzzy constructs by comparing overall and CRI2-specific support. The study showed that more than 86% of the data contained fuzzy values, and that the borderline group for CRI2 consisted of 2% of the study group. It was also confirmed that most fuzzy constructs were good representatives of the borderline CRI2 patient group.

[1]  F Golliot,et al.  Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. , 2001, JAMA.

[2]  Klaus-Peter Adlassnig,et al.  Artificial-intelligence-based hospital-acquired infection control. , 2009, Studies in health technology and informatics.

[3]  G Hripcsak,et al.  Writing Arden Syntax Medical Logic Modules. , 1994, Computers in biology and medicine.

[4]  Masoud Nikravesh,et al.  Forging New Frontiers: Fuzzy Pioneers II , 2007 .

[5]  R. Haley,et al.  The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. , 1985, American journal of epidemiology.

[6]  K. Adlassnig,et al.  Fuzzy-Based Nosocomial Infection Control , 2008 .

[7]  Jeroen S de Bruin,et al.  Assessing the clinical uses of fuzzy detection results in the automated detection of CVC-related infections: a preliminary report. , 2012, Studies in health technology and informatics.

[8]  R Consunji,et al.  Increased resource use associated with catheter-related bloodstream infection in the surgical intensive care unit. , 2001, Archives of surgery.

[9]  R. Evans European Centre for Disease Prevention and Control. , 2014, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[10]  Johan Decruyenaere,et al.  Clinical and economic outcomes in critically ill patients with nosocomial catheter-related bloodstream infections. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  R. Gaynes,et al.  Accuracy of Reporting Nosocomial Infections In Intensive-Care–Unit Patients to the National Nosocomial Infections Surveillance System: A Pilot Study , 1998, Infection Control & Hospital Epidemiology.

[12]  C. Brun-Buisson,et al.  Outcomes of primary and catheter-related bacteremia. A cohort and case-control study in critically ill patients. , 2001, American journal of respiratory and critical care medicine.

[13]  L. Mermel,et al.  Prevention of intravascular catheter-related infections. , 1994, Annals of internal medicine.

[14]  Joshua A. Doherty,et al.  Automated Surveillance for Central Line–Associated Bloodstream Infection in Intensive Care Units , 2008, Infection Control & Hospital Epidemiology.

[15]  Klaus-Peter Adlassnig,et al.  Effectiveness of an automated surveillance system for intensive care unit-acquired infections , 2013, J. Am. Medical Informatics Assoc..

[16]  A Lepape,et al.  Automated detection of nosocomial infections: evaluation of different strategies in an intensive care unit 2000-2006. , 2011, The Journal of hospital infection.