Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
PLoS One. 2019 Mar 7;14(3):e0213555. doi: 10.1371/journal.pone.0213555. eCollection 2019.
To evaluate the prevalence and predictors of peripherally inserted central catheter-associated bloodstream infection (PBSI) and PBSI-related death in hospitalized adult patients.
A retrospective multicenter cohort of consecutive patients who underwent PICC placement from October 2016 to September 2017 at four institutes was assembled. Using multivariable logistic and Cox-proportional hazards regression models, all risk factors were analyzed for their association with PBSI. Multivariable logistic models were used to evaluate predictors of PBSI-related death.
During the study period, a total of 929 PICCs were inserted in 746 patients for a total of 17,913 catheter days. PBSI occurred in 58 patients (6.2%), with an infection rate of 3.23 per 1,000 catheter days. Number of catheter lumens [double lumen, odds ratio (OR) 5.295; 95% confidence interval (CI), 2.220-12.627; hazard ration (HR) 3.569; 95% CI, 1.461-8.717], PICC for chemotherapy (OR 4.94; 95% CI, 1.686-14.458; HR 7.635; 95% CI, 2.775-21.007), and hospital length of stay (OR 2.23; 95% CI, 1.234-4.049; HR 1.249; 95% CI, 0.659-2.368) were associated with PBSI. Risk factors, such as receiving chemotherapy (OR 54.911; 95% CI, 2.755-1094.326), presence of diabetes (OR 11.712; 95% CI, 1.513-90.665), and advanced age (OR 1.116; 95% CI 1.007-1.238), were correlated with PBSI-related death.
Our results indicated that risk factors associated with PBSI included the number of catheter lumens, the use of PICCs for chemotherapy, and the hospital length of stay. Furthermore, PBSI-related death was common in patients undergoing chemotherapy, diabetics, and elderly patients.
评估住院成年患者经外周中心静脉置管（PICC）相关血流感染（PBSI）及 PBSI 相关死亡的发生率和预测因素。
本研究采用回顾性多中心队列研究，纳入 2016 年 10 月至 2017 年 9 月期间在四家机构接受 PICC 置管的连续患者。采用多变量逻辑和 Cox 比例风险回归模型，分析所有危险因素与 PBSI 的相关性。采用多变量逻辑模型评估 PBSI 相关死亡的预测因素。
研究期间，746 例患者共置入 929 根 PICC，总导管留置时间为 17913 天。58 例（6.2%）患者发生 PBSI，感染率为 3.23/1000 导管天。导管管腔数（双腔管腔，比值比[OR]5.295；95%置信区间[CI]2.220-12.627；风险比[HR]3.569；95%CI 1.461-8.717）、PICC 用于化疗（OR 4.94；95%CI 1.686-14.458；HR 7.635；95%CI 2.775-21.007）和住院时间（OR 2.23；95%CI 1.234-4.049；HR 1.249；95%CI 0.659-2.368）与 PBSI 相关。有化疗、糖尿病和高龄等危险因素与 PBSI 相关死亡相关（OR 54.911；95%CI 2.755-1094.326）、（OR 11.712；95%CI 1.513-90.665）和（OR 1.116；95%CI 1.007-1.238）。
本研究结果表明，与 PBSI 相关的危险因素包括导管腔数、化疗用 PICC 置管和住院时间。此外，化疗、糖尿病和老年患者 PBSI 相关死亡较为常见。
