Abstract：
OBJECTIVE: Peripherally inserted central catheters are commonly used in cancer patients and provide vascular access for the administration of chemotherapy, antibiotics, or parenteral nutrition. Besides many advantages, they represent a source of possible complications such as catheter related blood stream infection, catheter occlusion, or thrombosis. In this study, the catheter-related complication rate between oncologic and non-oncologic patients was compared.
METHODS: This retrospective cohort-study included 411 patients who underwent their first catheter placement at the Vienna General Hospital-Medical University of Vienna from January 2013 to June 2018. Patient demographics and catheter-related parameters were collected and statistically analyzed using a competing risk model.
RESULTS: Mean catheter dwell time was 27.75 days. The overall complication rate was 7.54% (2.72 per 1000 catheter days). Underlying malignant disease (hazard ratio: 0.351, 95% confidence interval [CI]: 0.133-0.929, P = .035) and chemotherapy administration (hazard ratio: 2.837, 95% CI: 1.088-7.394, P = .033) were significantly associated with the occurrence of any kind of complication. Catheter related blood stream infection was observed among 11 (2.68%) patients and again significantly associated with chemotherapy administration (hazard ratio: 4.545, 95% CI: 1.178-17.539; P = .028). Thrombosis was found in 7 (1.70%) patients and occlusion in 13 (3.16%) cases.
UNASSIGNED: Choice of venous access is an interdisciplinary decision with emphasis on patient participation. In oncologic patients, our data suggests that the benefits of peripherally inserted central catheters regarding costs, invasiveness, and accessibility might be outweighed by the higher rate of complications associated with the device. This becomes even more important in a community care setting, where standardized handling procedures and patient education play a pivotal role in device safety.
METHODS: This retrospective cohort-study included 411 patients who underwent their first catheter placement at the Vienna General Hospital-Medical University of Vienna from January 2013 to June 2018. Patient demographics and catheter-related parameters were collected and statistically analyzed using a competing risk model.
RESULTS: Mean catheter dwell time was 27.75 days. The overall complication rate was 7.54% (2.72 per 1000 catheter days). Underlying malignant disease (hazard ratio: 0.351, 95% confidence interval [CI]: 0.133-0.929, P = .035) and chemotherapy administration (hazard ratio: 2.837, 95% CI: 1.088-7.394, P = .033) were significantly associated with the occurrence of any kind of complication. Catheter related blood stream infection was observed among 11 (2.68%) patients and again significantly associated with chemotherapy administration (hazard ratio: 4.545, 95% CI: 1.178-17.539; P = .028). Thrombosis was found in 7 (1.70%) patients and occlusion in 13 (3.16%) cases.
UNASSIGNED: Choice of venous access is an interdisciplinary decision with emphasis on patient participation. In oncologic patients, our data suggests that the benefits of peripherally inserted central catheters regarding costs, invasiveness, and accessibility might be outweighed by the higher rate of complications associated with the device. This becomes even more important in a community care setting, where standardized handling procedures and patient education play a pivotal role in device safety.
摘要：
目的：外周插入的中心导管通常用于癌症患者，为化疗提供血管通路，抗生素,或肠胃外营养。除了许多优点，它们代表了可能的并发症的来源，例如导管相关的血流感染，导管闭塞,或血栓形成。在这项研究中,比较了肿瘤患者和非肿瘤患者的导管相关并发症发生率.
方法：这项回顾性队列研究包括411例患者，这些患者于2013年1月至2018年6月在维也纳总医院-维也纳医科大学首次置入导管。收集患者的人口统计学和导管相关参数，并使用竞争风险模型进行统计分析。
结果：平均导管停留时间为27.75天。总并发症发生率为7.54%（2.72/1000导管天）。潜在恶性疾病（风险比：0.351，95％置信区间[CI]：0.133-0.929，P=.035）和化疗（风险比：2.837，95％CI：1.088-7.394，P=.033）与任何类型的并发症的发生显着相关。在11例（2.68％）患者中观察到导管相关血流感染，并且再次与化疗药物显着相关（风险比：4.545，95％CI：1.178-17.539；P=0.028）。血栓形成7例（1.70％），闭塞13例（3.16％）。
■静脉通路的选择是一个跨学科的决定，重点是患者的参与。在肿瘤患者中，我们的数据表明，外周插入中心导管在成本方面的好处，侵入性,与装置相关的并发症发生率较高，可能会超过可及性。这在社区护理环境中变得更加重要，标准化的处理程序和患者教育在设备安全中起着关键作用。
方法：这项回顾性队列研究包括411例患者，这些患者于2013年1月至2018年6月在维也纳总医院-维也纳医科大学首次置入导管。收集患者的人口统计学和导管相关参数，并使用竞争风险模型进行统计分析。
结果：平均导管停留时间为27.75天。总并发症发生率为7.54%（2.72/1000导管天）。潜在恶性疾病（风险比：0.351，95％置信区间[CI]：0.133-0.929，P=.035）和化疗（风险比：2.837，95％CI：1.088-7.394，P=.033）与任何类型的并发症的发生显着相关。在11例（2.68％）患者中观察到导管相关血流感染，并且再次与化疗药物显着相关（风险比：4.545，95％CI：1.178-17.539；P=0.028）。血栓形成7例（1.70％），闭塞13例（3.16％）。
■静脉通路的选择是一个跨学科的决定，重点是患者的参与。在肿瘤患者中，我们的数据表明，外周插入中心导管在成本方面的好处，侵入性,与装置相关的并发症发生率较高，可能会超过可及性。这在社区护理环境中变得更加重要，标准化的处理程序和患者教育在设备安全中起着关键作用。
