Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

Crispin, Alexander; Thul, P.; Arnold, Dirk; Schild, Sandra; Weimann, Arved

doi:10.1159/000162286

Cited by 23 publications

(22 citation statements)

References 23 publications

(40 reference statements)

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“…14,25,35,38,39 However, in 3 studies researchers relied on patients’ self-reported information in identifying infections. 12,13,26 A major threat to the internal validity was related to the small sample sizes, which may limit the ability to detect significant associations. 12,23,24,26,30,35,38 Also, bivariate analysis was frequently used to identify risk factors without adjusting for major confounding variables.…”

Section: Resultsmentioning

confidence: 99%

The prevalence of infections and patient risk factors in home health care: A systematic review

Shang¹,

Ma²,

Poghosyan³

et al. 2014

American Journal of Infection Control

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Background Home health care (HHC) has been the fastest growing health care sector for the past 3 decades. The uncontrolled home environment, increased use of indwelling devices, and the complexity of illnesses among HHC patients lead to increased risk for infections. Methods A systematic review of studies evaluating infection prevalence and risk factors among adult patients who received HHC services was conducted and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Literature was searched using Medline, PubMed, and the Cumulative Index to Nursing and Allied Health as well as hand searching. Two reviewers independently assessed study quality using validated quality assessment checklists. Results Twenty-five studies met the inclusion criteria and were reviewed. The infection rates and identified risk factors for infections varied dramatically between studies. In general, patients receiving home parental nutrition treatments had higher infection rates than patients receiving home infusion therapy. The identified risk factors were limited by small sample sizes and other methodologic flaws. Conclusions Establishing a surveillance system for HHC infections, identifying patients at high risk for infections, tailoring HHC and patient education based on patient living conditions, and facilitating communication between different health care facilities will enhance infection control in HHC settings. Future studies should use a nationally representative sample and multivariate analysis for the identification of risk factors for infections.

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Section: Resultsmentioning

confidence: 99%

The prevalence of infections and patient risk factors in home health care: A systematic review

Shang¹,

Ma²,

Poghosyan³

et al. 2014

American Journal of Infection Control

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“…Another prospective study by the same research group, found a CRBSI rate of 0.35 per 1000 catheter days and 0.60 per 1000 HPN days [23]. Other studies have reported CRBSI rates ranging from 0.41 to 1.7 per 1000 catheter days [21, 22, 24, 25, 30]. We did not find any significant difference in the incidence of CRBSI across the three types of VAD, though it is to be noted that of a total of 408 VADs in this study, only 11 (2.7%) were TCCs.…”

Section: Discussionmentioning

confidence: 99%

Incidence of and factors associated with catheter-related bloodstream infection in patients with advanced solid tumors on home parenteral nutrition managed using a standardized catheter care protocol

et al. 2017

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BackgroundCatheter-related bloodstream infections (CRBSIs) are associated with high morbidity and mortality as well as increased medical costs. Cancer patients, who are often immunocompromised, are susceptible to CRBSI while receiving home parenteral nutrition (HPN). We evaluated the incidence of and factors associated with CRBSIs in cancer patients undergoing HPN managed using a standardized catheter care protocol.MethodsThis is a retrospective cohort study of 335 cancer patients receiving HPN between January 2012 and July 2015. The primary outcome of interest was the incidence of CRBSI expressed as events per 1000 HPN days. HPN days were calculated from the start date with the home infusion provider until the discontinuation of HPN, or the removal of the venous access device (VAD), or the death of the patient. The VADs used were either peripherally inserted central catheters (PICCs) or a subcutaneous implanted port or tunneled central catheters (TCCs). Univariate Poisson regression analyses were used to determine the variables associated with CRBSIs.ResultsOf 335 patients, 193 were females and 142 were males. The most common cancer types were colorectal, pancreatic, ovarian and stomach. A total of 408 VADs in 335 patients were studied, covering a total of 29,403 HPN days. Of 408 VADs, 206 (50.5%) were ports, 191 (46.8%) were PICCs, and 7 (2.7%) were TCCs. The median duration of HPN was 54 days. A total of 16 CRBSI episodes were recorded (8 in ports, 7 in PICCs and 1 in TCCs). The median duration from the start of HPN to the development of CRBSI episodes was 43.5 days. The overall incidence of CRBSI per 1000 HPN days was 0.54 (95% confidence interval: 0.32–0.86). Upon univariate analysis, no variables were found to be statistically significantly associated with CRBSI incidence.ConclusionsWe found a low rate of CRBSI following a standardized catheter maintenance protocol in a high-risk oncology population undergoing HPN.

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“…1,[3][4][5][6][7][8][9][10][11][12][13] In children, infection rates as high as 7 per 1000 days have been reported. 14 The important issue, however, is how this infection risk can be lowered.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for the Development of Catheter‐Related Bloodstream Infections in Patients Receiving Home Parenteral Nutrition

Buchman

Opilla²,

Kwasny

et al. 2013

J Parenter Enteral Nutr

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Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

Cited by 23 publications

References 23 publications

The prevalence of infections and patient risk factors in home health care: A systematic review

The prevalence of infections and patient risk factors in home health care: A systematic review

Incidence of and factors associated with catheter-related bloodstream infection in patients with advanced solid tumors on home parenteral nutrition managed using a standardized catheter care protocol

Risk Factors for the Development of Catheter‐Related Bloodstream Infections in Patients Receiving Home Parenteral Nutrition

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