Abstract：
BACKGROUND: Incidence of central venous catheter (CVC)-related thrombosis in critically ill patients remains ambiguous and its association with potential hazardous sequelae unknown. The primary aim of the study was to evaluate the epidemiology of CVC-related thrombosis; secondary aims were to assess the association of catheter-related thrombosis with catheter-related infection, pulmonary embolism and mortality.
METHODS: This was a single-center, prospective observational study conducted at a tertiary intensive care unit (ICU) in the Netherlands. The study population consisted of CVC placements in adult ICU patients with a minimal indwelling time of 48 h. CVC-related thrombosis was diagnosed with ultrasonography. Primary outcomes were prevalence and incidence, incidence was reported as the number of cases per 1000 indwelling days.
RESULTS: 173 CVCs in 147 patients were included. Median age of patients was 64.0 [IQR: 52.0, 72.0] and 71.1 % were male. Prevalence of thrombosis was 0.56 (95 % CI: 0.49, 0.63) and incidence per 1000 indwelling days was 65.7 (95 % CI: 59.0, 72.3). No association with catheter-related infection was found (p = 0.566). There was a significant association with pulmonary embolism (p = 0.022). All 173 CVCs were included in the survival analysis. Catheter-related thrombosis was associated with a lower 28-day mortality risk (hazard ratio: 0.39, 95 % CI: 0.17, 0.87).
CONCLUSIONS: In critically ill patients, prevalence and incidence of catheter-related thrombosis were high. Catheter-related thrombosis was not associated with catheter-related infections, but was associated with pulmonary embolism and a decreased mortality risk.
METHODS: This was a single-center, prospective observational study conducted at a tertiary intensive care unit (ICU) in the Netherlands. The study population consisted of CVC placements in adult ICU patients with a minimal indwelling time of 48 h. CVC-related thrombosis was diagnosed with ultrasonography. Primary outcomes were prevalence and incidence, incidence was reported as the number of cases per 1000 indwelling days.
RESULTS: 173 CVCs in 147 patients were included. Median age of patients was 64.0 [IQR: 52.0, 72.0] and 71.1 % were male. Prevalence of thrombosis was 0.56 (95 % CI: 0.49, 0.63) and incidence per 1000 indwelling days was 65.7 (95 % CI: 59.0, 72.3). No association with catheter-related infection was found (p = 0.566). There was a significant association with pulmonary embolism (p = 0.022). All 173 CVCs were included in the survival analysis. Catheter-related thrombosis was associated with a lower 28-day mortality risk (hazard ratio: 0.39, 95 % CI: 0.17, 0.87).
CONCLUSIONS: In critically ill patients, prevalence and incidence of catheter-related thrombosis were high. Catheter-related thrombosis was not associated with catheter-related infections, but was associated with pulmonary embolism and a decreased mortality risk.
摘要：
背景：危重患者中心静脉导管（CVC）相关血栓形成的发生率仍不明确，其与潜在危险后遗症的关系未知。该研究的主要目的是评估CVC相关血栓形成的流行病学；次要目的是评估导管相关血栓形成与导管相关感染的关系。肺栓塞和死亡率。
方法：这是一个单中心，在荷兰的三级重症监护病房（ICU）进行的前瞻性观察性研究。研究人群包括CVC放置在ICU患者中，最小留置时间为48h。超声检查诊断为CVC相关血栓形成。主要结果是患病率和发病率，发病率报告为每1000个留置日的病例数.
结果：纳入147例患者的173例CVC。患者的中位年龄为64.0[IQR:52.0,72.0],71.1%为男性。血栓形成的患病率为0.56（95％CI：0.49，0.63），每1000个留置日的发生率为65.7（95％CI：59.0，72.3）。未发现与导管相关性感染相关(p=0.566)。与肺栓塞有显著关联(p=0.022)。所有173例CVC均纳入生存分析。导管相关血栓形成与较低的28天死亡风险相关(风险比:0.39,95%CI:0.17,0.87)。
结论：在危重患者中，导管相关血栓形成的患病率和发生率较高.导管相关性血栓形成与导管相关性感染无关，但与肺栓塞和死亡风险降低相关.
方法：这是一个单中心，在荷兰的三级重症监护病房（ICU）进行的前瞻性观察性研究。研究人群包括CVC放置在ICU患者中，最小留置时间为48h。超声检查诊断为CVC相关血栓形成。主要结果是患病率和发病率，发病率报告为每1000个留置日的病例数.
结果：纳入147例患者的173例CVC。患者的中位年龄为64.0[IQR:52.0,72.0],71.1%为男性。血栓形成的患病率为0.56（95％CI：0.49，0.63），每1000个留置日的发生率为65.7（95％CI：59.0，72.3）。未发现与导管相关性感染相关(p=0.566)。与肺栓塞有显著关联(p=0.022)。所有173例CVC均纳入生存分析。导管相关血栓形成与较低的28天死亡风险相关(风险比:0.39,95%CI:0.17,0.87)。
结论：在危重患者中，导管相关血栓形成的患病率和发生率较高.导管相关性血栓形成与导管相关性感染无关，但与肺栓塞和死亡风险降低相关.
