Frailty and Neutrophil Lymphocyte Ratio as predictors of mortality in patients with CAUTI or CLABSI in the Neurosurgical ICU: Insights from a Retrospective Study in a Developing Country

We aim to evaluate the role of frailty and inflammatory markers in predicting the short-term outcomes after catheter-associated urinary tract infections (CAUTI) and central line–associated bloodstream infections (CLABSI). Data regarding the patients’ characteristics, isolates on CAUTI and CLABSI, antibiotic susceptibility, frailty (11-point Modified Frailty Index), and inflammatory markers were retrospectively collected. Their impact on the short-term outcomes was assessed using regression modeling response. One hundred and one patients with CAUTI ( n = 71) and CLABSI ( n = 30) between January 2018 and December 2019 were included in this study. The pooled incidence rates for CAUTI were 5.50 and for CLABSI 3.58 episodes/1000 catheter-days. We observed 74.7% drug resistance in our CAUTI isolates and 93.3% in CLABSI. In the multivariate analysis, frailty ( P = 0.006), neutrophil/lymphocyte ratio (NLR) ( P = 0.007) and the presence of sepsis ( P = 0.029) were found to be significant predictors of in-hospital mortality in CAUTI. In patients with CLABSI, frailty ( P = 0.029) and NLR ( P = 0.029) were found significant and along with sepsis ( P = 0.069) resulted in a regression model with good accuracy in predicting mortality. The receiver operating characteristic curve showed that 11-point Modified Frailty Index and NLR as well as the regression model significantly predicted mortality with an area under the curve of 86.1%, 81.4%, and 95.4%, respectively, in CAUTI, and 70.9%, 77.8%, and 95.2%, respectively, in CLABSI.