Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.
J Clin Nurs. 2017 Dec;26(23-24):4726-4733. doi: 10.1111/jocn.13825. Epub 2017 Jun 20.
To identify whether patients with advanced cancers were at high risk of peripherall"y inserted central catheter-related complications when treated with concurrent chemo-radiotherapy.
Peripherally inserted central catheters are widely used in chemotherapy. However, catheter usage may elevate the risks of infections and thrombosis. It is important to identify the patients with high risk of peripherally inserted central catheter-related complications. To date, little is known about peripherally inserted central catheter-related complications in patients with advanced cancers and receiving concurrent chemo-radiotherapy.
Five hundred and sixty-nine cancer patients with advanced cancers and treated by chemo-radiotherapy were analysed in the study. The incidences of peripherally inserted central catheter-related complications were investigated.
Univariable and multivariable logistic regression analyses were employed for identification of risk factors.
Eighty-six (15.1%) patients exhibited peripherally inserted central catheter-related infectious complications, of which 6.3% were local infection, 3.9% were catheter-related bloodstream infection and 4.9% were exit-site infection. Sixty-five (11.4%) developed symptomatic peripherally inserted central catheter-related thrombosis, and 52 (9.1%) were suffering from phlebitis. The overall complication rate was 53.1%. The univariable logistic regression and multivariate analysis showed that comorbidity (OR 1.51, p = .0148) and body mass index (OR 1.46, p = .0157), and duration of radio-chemotherapy (OR 1.4733, p = .0049) were significantly associated with peripherally inserted central catheter-related complications. Patients with peripherally inserted central catheter-related complications showed lower 5-year survival rate than those without peripherally inserted central catheter-related complications.
Identification of risk factors for peripherally inserted central catheter-related complications in patients with advanced cancer before catheter usage may play an important role in improvement of the prognosis.
Doctors need to be aware of the risk of peripherally inserted central catheter-related complications in patients with advanced cancers.
确定接受同期放化疗的晚期癌症患者外周置入中心静脉导管相关并发症的高危因素。
外周置入中心静脉导管在化疗中广泛应用，但导管使用可能会增加感染和血栓形成的风险。识别外周置入中心静脉导管相关并发症高危患者非常重要。迄今为止，对于接受同期放化疗的晚期癌症患者外周置入中心静脉导管相关并发症知之甚少。
对 569 例接受放化疗的晚期癌症患者进行分析，研究外周置入中心静脉导管相关并发症的发生率。
采用单变量和多变量逻辑回归分析确定危险因素。
86 例（15.1%）患者出现外周置入中心静脉导管相关感染性并发症，其中局部感染 6.3%，导管相关血流感染 3.9%，出口部位感染 4.9%。65 例（11.4%）出现有症状的外周置入中心静脉导管相关血栓形成，52 例（9.1%）出现静脉炎。总的并发症发生率为 53.1%。单变量逻辑回归和多变量分析显示，合并症（OR 1.51，p=0.0148）和体质指数（OR 1.46，p=0.0157）以及放化疗时间（OR 1.4733，p=0.0049）与外周置入中心静脉导管相关并发症显著相关。发生外周置入中心静脉导管相关并发症的患者 5 年生存率低于未发生外周置入中心静脉导管相关并发症的患者。
在使用导管前识别晚期癌症患者外周置入中心静脉导管相关并发症的危险因素，可能对改善预后起到重要作用。
医生需要意识到晚期癌症患者发生外周置入中心静脉导管相关并发症的风险。
