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日本中心静脉置管患者以及短肠综合征患者中导管相关并发症的发生率。

Incidence of catheter-related complications among Japanese patients with central venous catheters as well as patients with short bowel syndrome.

作者信息

Wing Vicki K, Song Yan, Xiang Cheryl, Liu Xinyue, Macaulay Dendy, Ponsillo Maria, Blumentals William A

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Analysis Group, Boston, MA, USA.

出版信息

Clin Exp Gastroenterol. 2018 Nov 28;11:439-445. doi: 10.2147/CEG.S172430. eCollection 2018.

Abstract

PURPOSE

Short bowel syndrome (SBS) is a serious rare disorder that is usually managed with parenteral nutrition. Central venous catheter (CVC)-related complications are known to occur, but their incidence rates (IRs) in Japan are unknown. The aim of this study was to estimate the incidence of complications in Japanese patients with CVCs, including patients with SBS using CVCs.

PATIENTS AND METHODS

A retrospective cohort study in 64,817 patients with CVCs, including 81 patients with SBS, between April 2008 and October 2016 using a claims database in Japan was conducted. IRs of complications were calculated as total events divided by total catheter-days among all patients with CVCs and among patients with SBS.

RESULTS

The majority (>90%) of patients in the CVC and SBS cohorts were ≥18 years old. Overall, IRs of any type of complication were numerically higher in patients with SBS compared with all patients with CVCs (2.68 vs 1.95 cases per 1,000 catheter-days, respectively). Among patients with SBS, septicemia, infection, and inflammatory reaction were the only complications observed. The complications with the highest incidence were catheter-related bloodstream infections (CRBSIs) in both the overall CVC cohort and the SBS cohort with IRs of 1.35 and 2.68 cases per 1,000 catheter-days, respectively. The IR of any CVC-related complication was numerically higher in patients with SBS with cancer vs without cancer (3.44 vs 1.86 cases per 1,000 catheter-days, respectively).

CONCLUSION

Our study quantifies the incidence of complications in patients with CVCs, including those with SBS, in Japan.

摘要

目的

短肠综合征(SBS)是一种严重的罕见疾病,通常采用肠外营养治疗。已知中心静脉导管(CVC)相关并发症会发生,但在日本其发生率尚不清楚。本研究的目的是估计日本使用CVC的患者(包括使用CVC的SBS患者)的并发症发生率。

患者与方法

利用日本的索赔数据库,对2008年4月至2016年10月期间64817例使用CVC的患者(包括81例SBS患者)进行了一项回顾性队列研究。并发症发生率计算为所有使用CVC的患者以及SBS患者中总事件数除以总导管日数。

结果

CVC队列和SBS队列中的大多数患者(>90%)年龄≥18岁。总体而言,SBS患者中任何类型并发症的发生率在数值上高于所有使用CVC的患者(分别为每1000导管日2.68例和1.95例)。在SBS患者中,仅观察到败血症、感染和炎症反应。总体CVC队列和SBS队列中发生率最高的并发症均为导管相关血流感染(CRBSI),发生率分别为每1000导管日1.35例和2.68例。患有癌症的SBS患者中任何CVC相关并发症的发生率在数值上高于未患癌症的患者(分别为每1000导管日3.44例和1.86例)。

结论

我们的研究对日本使用CVC的患者(包括SBS患者)的并发症发生率进行了量化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/028c/6276634/a0b8e49f7f07/ceg-11-439Fig1.jpg

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