Fabiani Adam, Aversana Nicola, Santoro Marilena, Sanson Gianfranco
Department of Biomedicine and Prevention, University of Rome Tor Vergata - Via Montpellier 1, Rome, Italy; Cardiothoracic-Vascular Department, Cardiac Surgery Intensive Care Unit, Azienda Sanitaria Universitaria Giuliano-Isontina - Strada di Fiume 447, Trieste, Italy.
School of Nursing, University of Trieste, Strada di Fiume 447, Trieste, Italy.
Thromb Res. 2024 Apr;236:117-126. doi: 10.1016/j.thromres.2024.02.022. Epub 2024 Feb 26.
Long peripheral catheters (LPCs) and midline catheters (MCs) are indiscriminately labelled with different names, leading to misclassifications both in primary and secondary studies. The available studies used different methods to report the incidence of catheter-related complications, affecting the possibility of properly comparing the catheter outcomes. The aim of this review was to explore the complications related to LPCs and MCs after reclassifying according to their length.
Systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, conducted on PubMed, Scopus and CINAHL databases. The study protocol was registered in the International Prospective Register of Systematic Reviews. Data regarding LPCs and MCs were compared. Catheter outcomes were classified into major and minor complications, recomputed and reported as cases/1000 catheter-days.
Fourteen studies were included. Over-half of the devices were correctly labelled by the authors, misclassifications affected particularly LPCs improperly labelled MCs. The cumulative incidence of catheter-related bloodstream infections was 0.3 and 0.4/1000 catheter-days, that of symptomatic catheter-related thrombosis was 0.9 and 1.8/1000 catheter-days for MCs and LPCs, respectively. Minor complications and catheter failure were higher for LPCs.
A misclassification exists in the labelling of MCs and LPCs. A widespread heterogeneity of diagnostic criteria adopted to classify the catheters' outcomes was found, exposing the risk of misestimating the incidence of complications and undermining the possibility of effectively comparing results of the published research. We proposed a list of definitions and relevant variables as a first step toward the development of standardized criteria to be adopted for research purposes.
长外周导管（LPC）和中线导管（MC）被随意贴上不同的标签，这导致在初级和次级研究中均出现分类错误。现有研究使用不同方法报告导管相关并发症的发生率，影响了正确比较导管使用结果的可能性。本综述的目的是在根据长度重新分类后，探讨与LPC和MC相关的并发症。
基于系统评价和Meta分析的首选报告项目进行系统文献综述，在PubMed、Scopus和CINAHL数据库上开展。研究方案已在国际前瞻性系统评价注册库中注册。对有关LPC和MC的数据进行比较。将导管使用结果分为主要和次要并发症，重新计算并报告为每1000导管日的病例数。
纳入14项研究。超过一半的设备被作者正确标记，分类错误尤其影响了被错误标记为MC的LPC。导管相关血流感染的累积发生率分别为每1000导管日0.3例和0.4例，有症状的导管相关血栓形成的累积发生率，MC为每1000导管日0.9例，LPC为每1000导管日1.8例。LPC的次要并发症和导管失效情况更多。
MC和LPC的标签存在分类错误。发现用于对导管使用结果进行分类的诊断标准存在广泛异质性，这带来了错误估计并发症发生率的风险，并削弱了有效比较已发表研究结果的可能性。我们提出了一份定义和相关变量清单，作为朝着制定用于研究目的的标准化标准迈出的第一步。
