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化疗癌症患者与非癌症患者外周静脉穿刺中心静脉置管(PICC)相关血流感染的倾向评分匹配分析

Peripherally Inserted Central Venous Catheter (PICC) Related Bloodstream Infection in Cancer Patients Treated with Chemotherapy Compared with Noncancer Patients: A Propensity-Score-Matched Analysis.

作者信息

Larcher Romaric, Barrigah-Benissan Koko, Ory Jerome, Simon Claire, Beregi Jean-Paul, Lavigne Jean-Philippe, Sotto Albert

机构信息

PhyMedExp (Physiology and Experimental Medicine), INSERM (French Institute of Health and Medical Research), CNRS (French National Centre for Scientific Research), University of Montpellier, 34000 Montpellier, France.

Infectious and Tropical Diseases Department, Nimes University Hospital, Place du Professeur Robert Debre, 30000 Nimes, France.

出版信息

Cancers (Basel). 2023 Jun 20;15(12):3253. doi: 10.3390/cancers15123253.

Abstract

The use of peripherally inserted central catheters (PICCs) has increased in cancer patients. This study aimed to compare the incidence of PICC-related bloodstream infections (PICCR-BSIs) in cancer patients treated with chemotherapy and in noncancer patients. We performed a secondary analysis from a retrospective, single-center, observational cohort. The PICCR-BSI incidence rates in cancer and noncancer patients were compared after 1:1 propensity-score matching. Then, the factors associated with PICCR-BSI were assessed in a Cox model. Among the 721 PICCs (627 patients) included in the analysis, 240 were placed in cancer patients for chemotherapy and 481 in noncancer patients. After propensity-score matching, the PICCR-BSI incidence rate was 2.6 per 1000 catheter days in cancer patients and 1.0 per 1000 catheter days in noncancer patients ( < 0.05). However, after adjusting for variables resulting in an imbalance between groups after propensity-score matching, only the number of PICC lumens was independently associated with PICCR-BSI (adjusted hazard ratio 1.81, 95% confidence interval: 1.01-3.22; = 0.04). In conclusion, the incidence rate of PICCR-BSI is higher in cancer patients treated with chemotherapy than in noncancer patients, but our results also highlight the importance of limiting the number of PICC lumens in such patients.

摘要

外周静脉穿刺中心静脉导管(PICC)在癌症患者中的使用有所增加。本研究旨在比较接受化疗的癌症患者和非癌症患者中PICC相关血流感染(PICCR-BSI)的发生率。我们对一项回顾性、单中心观察性队列研究进行了二次分析。在1:1倾向评分匹配后,比较癌症患者和非癌症患者的PICCR-BSI发生率。然后,在Cox模型中评估与PICCR-BSI相关的因素。纳入分析的721根PICC(627例患者)中,240根用于癌症患者化疗,481根用于非癌症患者。倾向评分匹配后,癌症患者的PICCR-BSI发生率为每1000导管日2.6例,非癌症患者为每1000导管日1.0例(<0.05)。然而,在对倾向评分匹配后导致组间不平衡的变量进行调整后,只有PICC管腔数量与PICCR-BSI独立相关(调整后风险比1.81,95%置信区间:1.01-3.22;P=0.04)。总之,接受化疗的癌症患者中PICCR-BSI的发生率高于非癌症患者,但我们的结果也凸显了限制此类患者PICC管腔数量的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3530/10296793/effe2f986c96/cancers-15-03253-g001.jpg

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