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Five-year outcome of peripherally inserted central catheters in adults: a separated infectious and thrombotic complications analysis

Published online by Cambridge University Press:  10 December 2020

Samuel González
Affiliation:
Intensive Care Unit, Hospital Universitario HLA Moncloa, Madrid, Spain
Pedro Jiménez
Affiliation:
Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Sevilla, Spain
Pedro Saavedra
Affiliation:
Mathematics Department, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Desiré Macías
Affiliation:
Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Sevilla, Spain
Ana Loza
Affiliation:
Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Sevilla, Spain
Cristóbal León
Affiliation:
Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Sevilla, Spain
Magdalena López
Affiliation:
Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Sevilla, Spain
Elena Pallejá
Affiliation:
Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Sevilla, Spain
Carmen Rosa Hernández-Socorro
Affiliation:
Radiology Department, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Sergio Ruiz-Santana
Affiliation:
Intensive Care Unit, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Corresponding
E-mail address:

Abstract

Objective:

To assess infectious and thrombotic complications of peripherally inserted central catheters (PICCs) in adults.

Design:

A 5-year prospective cohort study.

Setting:

Tertiary-care teaching hospital in Seville, Spain.

Patients:

Adult patients undergoing PICC insertion.

Methods:

Catheter-associated bloodstream infection (CABSI) including catheter-related bloodstream infection (CRBSI), primary bacteremia (PB), and upper extremity deep vein thrombosis (UEDVT) were recorded. Independent predictors of complications were assessed by multivariate analysis.

Results:

In total, 1,142 PICCs were inserted, with 153,191 catheter days (median, 79). Complications included 66 cases of CABSI (5.78%; 0.43‰ catheter days), 38 cases of CRBSI (3.33%; 0.25‰ catheter days), 28 cases of PB (2.45%; 0.18‰ catheter days), and 23 cases of UEDVT (2.01%; 0.15‰ catheter days). The median times to infection were 24, 41, and 60 days for CRBSI, PB, and UEDVT, respectively. Parenteral nutrition (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.77–6.52) and admission to the hematology ward (OR, 4.90; 95% CI, 2.25–10.71) were independently associated with CRBSI and PB, respectively. Admission to the hematology ward (OR, 12.46; 95% CI, 2.49–62.50) or to the oncology ward (OR, 7.89; 95% CI, 1.77–35.16) was independently associated with UEDVT. The crude mortality rate was 24.8%. Only 2 patients died of complications.

Conclusions:

PICCs showed a low rate of thrombotic and infectious complications. Compared to PB, CRBSI showed significantly different risk factors, a higher incidence density per catheter days, and a shorter median time to infection. Separate analyses of CRBSI and PB are more specific and clinically useful when analyzing infectious complications.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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