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在一项对9924根导管进行的观察性随访研究中,使用自动化数据脚本作为中心静脉导管(CVC)管理的质量保证措施,持续保持较低的导管相关感染(CRI)发生率。

Sustained low catheter related infection (CRI) incidence in an observational follow-up study of 9924 catheters using automated data scripts as quality assurance for central venous catheter (CVC) management.

作者信息

Rockholt Mika M, Agrell Tobis, Thorarinsdottir Hulda, Kander Thomas

机构信息

Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden.

Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, NYC, NY, USA.

出版信息

Infect Prev Pract. 2023 Feb 19;5(2):100273. doi: 10.1016/j.infpip.2023.100273. eCollection 2023 Jun.

Abstract

BACKGROUND

To maintain a low incidence of Catheter Related Infections (CRI) and Catheter Related Bloodstream Infections (CRBSI), continuous follow-up studies on catheter management are necessary. The aims of the present study were to investigate the incidence of catheter tip colonisation, CRI and CRBSI in the Region, to further explore the feasibility of automatic data collection and to investigate associations between independent variables and CRI.

METHODS

Data from electronic patient charts on all documented central venous catheter (CVC) insertions from multiple hospitals in southern Sweden, between March 2019 and August 2020, were automatically extracted. Multivariable regression analyses were used to identify associated risk factors.

RESULTS

In total, 9924 CVC insertions were included. The prevalence of CRI and CRBSI were 0.7% () and 0.02% () with incidences of 1.2/1000 catheter days and 0.3/1000 catheter days, respectively.

CONCLUSIONS

We found a sustained low incidence of CRI and CRBSI in the Region. Catheter tips were less likely to be colonised when the subclavian route was used compared to the internal jugular route and male sex as well as increased number of catheter lumens were associated with both catheter tip colonisation and CRI. By using automated scripts, data extraction was efficient and feasible but also demonstrated that real-time quality assurance should be recommended, since this is superior to current standard.

摘要

背景

为维持较低的导管相关感染(CRI)和导管相关血流感染(CRBSI)发生率,对导管管理进行持续的随访研究很有必要。本研究的目的是调查该地区导管尖端定植、CRI和CRBSI的发生率,进一步探索自动数据收集的可行性,并研究自变量与CRI之间的关联。

方法

自动提取了2019年3月至2020年8月期间瑞典南部多家医院所有记录在案的中心静脉导管(CVC)插入术的电子病历数据。采用多变量回归分析来识别相关风险因素。

结果

总共纳入了9924例CVC插入术。CRI和CRBSI的患病率分别为0.7%()和0.02%(),发生率分别为每1000导管日1.2例和每1000导管日0.3例。

结论

我们发现该地区CRI和CRBSI的发生率持续较低。与颈内静脉途径相比,采用锁骨下途径时导管尖端定植的可能性较小,男性以及导管腔数量增加与导管尖端定植和CRI均相关。通过使用自动化脚本,数据提取高效且可行,但也表明应推荐实时质量保证,因为这优于当前标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3116/10011737/1bb26765a0f4/gr1.jpg

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