Mohamed Jiffry Mohamed Z, Khan Aimal, Carmona Pires Felipe, Okam Nkechi A, Vargas Jonathan, Moin Kayvon, Josephs Meagan
Internal Medicine, Danbury Hospital, Danbury, USA.
Internal medicine, Danbury Hospital, Fairfield, USA.
Cureus. 2023 Feb 7;15(2):e34717. doi: 10.7759/cureus.34717. eCollection 2023 Feb.
Background Agranulocytosis secondary to cancer chemotherapy (ASCC) remains a leading cause of morbidity and mortality. Central line-associated bloodstream infections (CLABSI) are also particularly prevalent in these populations and may portend a poorer outcome. Our study serves to investigate the relationship between patients with agranulocytosis secondary to cancer chemotherapy and the insertion of a central venous catheter (CVC) with respect to in-hospital mortality. Methods and results We utilized the National Inpatient Survey 2019 database. We utilized the International Classification of Diseases (ICD)-10 CM codes to identify ASCC and other medical comorbidities. We utilized ICD-10 PCS codes to identify CVC insertions. Multivariate logistic regression was utilized to study the effect of CVC insertion on in-hospital mortality. In patients with ASCC, CVC insertion was associated with a higher in-hospital mortality (unadjusted: 11.9% vs. 1%, p<0.001, adjusted OR 19.27, 95% CI 5.84 - 65.6, p<0.001) adjusted for baseline characteristics and other comorbidities. Patients in the study cohort who were older than 70 years of age also had a higher in-hospital mortality relative to younger age groups (adjusted OR 2.31, 95% CI 1.04-5.13, p<0.039). Conclusion In patients with ASCC, CVC insertion during hospitalization is associated with higher in-hospital mortality.
癌症化疗继发的粒细胞缺乏症（ASCC）仍然是发病和死亡的主要原因。中心静脉导管相关血流感染（CLABSI）在这些人群中也特别普遍，并且可能预示着更差的预后。我们的研究旨在调查癌症化疗继发粒细胞缺乏症患者与中心静脉导管（CVC）插入之间关于住院死亡率的关系。方法和结果：我们使用了2019年全国住院患者调查数据库。我们使用国际疾病分类（ICD）-10 CM编码来识别ASCC和其他医学合并症。我们使用ICD-10 PCS编码来识别CVC插入。多因素逻辑回归用于研究CVC插入对住院死亡率的影响。在ASCC患者中，调整基线特征和其他合并症后，CVC插入与较高的住院死亡率相关（未调整：11.9%对1%，p<0.001，调整后的OR为19.27，95%CI为5.84 - 65.6，p<0.001）。研究队列中年龄大于70岁的患者相对于较年轻年龄组也有较高的住院死亡率（调整后的OR为2.31，95%CI为1.04 - 5.13，p<0.039）。结论：在ASCC患者中，住院期间插入CVC与较高的住院死亡率相关。
