Medically Attended Catheter Complications Are Common in Patients With Outpatient Central Venous Catheters.
Medically Attended Catheter Complications Are Common in Patients With Outpatient Central Venous Catheters.
复制标题
门诊中心静脉导管患者的医疗导管并发症很常见。
DOI：
10.1017/ice.2018.8
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发表时间：
2018
影响因子：
4.5
通讯作者：
Talbot,ThomasR
中科院分区：
文献类型：
--
作者：
Spires,StevenS;Rebeiro,PeterF;Miller,Mickie;Koss,Katie;Wright,PattyW;Talbot,ThomasR
目的 门诊中心静脉导管 (CVC) 的使用越来越频繁；然而，描述门诊机械并发症和中心导管相关血流感染 (CLABSI) 的数据有限。我们进行了一项回顾性观察队列研究，以了解这些并发症的负担，以阐明其对医疗保健系统的影响。 方法回顾性收集从范德比尔特大学医学中心出院、已安装 CVC 并入住范德比尔特家庭护理服务中心的患者的数据。分析了就医导管相关并发症 (CAC) 和门诊 CLABSI 的危险因素。 结果 143 名患者 (21.9%) 发生 CAC，总共 165 起离散 CAC 事件。其中，76 例（46%）需要至少 1 次去急诊室或住院，而其余 89 例（54%）需要门诊就诊。女性患者、CVC 管腔大于 1 的患者以及接受全肠外营养的患者发生 CAC 的风险显着增加。研究人群中发现的 CLABSI 绝对数量很少，为 16 例，占总队列的 2.4%。 结论 医疗护理导管并发症在 CVC 出院的门诊患者中很常见，减少这些事件应成为门诊质量改进计划的重点。感染控制医院流行病学 2018；39：439–444
OBJECTIVEOutpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line–associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system.METHODSData were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services. Risk factors for medically attended catheter-associated complications (CACs) and outpatient CLABSIs were analyzed.RESULTSA CAC developed in 143 patients (21.9%), for a total of 165 discrete CAC events. Among these, 76 (46%) required at least 1 visit to the emergency department or an inpatient admission, while the remaining 89 (54%) required an outpatient clinic visit. The risk for developing a CAC was significantly increased in female patients, patients with a CVC with >1 lumen, and patients receiving total parenteral nutrition. The absolute number of CLABSIs identified in the study population was small at 16, or 2.4% of the total cohort.CONCLUSIONSMedically attended catheter complications were common among outpatients discharged with a CVC, and reduction of these events should be the focus of outpatient quality improvement programs. Infect Control Hosp Epidemiol 2018;39:439–444