Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China.
Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China
BMJ Open. 2024 Mar 4;14(3):e080816. doi: 10.1136/bmjopen-2023-080816.
This study aims to explore the incidence of, and risk factors for medical adhesive-related skin injury (MARSI) at peripherally inserted central venous catheter (PICC) sites in patients with cancer.
A prospective observational cohort study was conducted at a tertiary hospital in Shenzhen, China.
This was a single-centre study conducted in a tertiary hospital in Shenzhen, China.
A total of 340 patients with cancer and PICC placement from January 2022 to June 2023 were selected using a convenience sampling method.
Factors potentially associated with PICC-related MARSI (PICC-MARSI) were recorded, including patient demographics, and catheter placement and maintenance. Patients were divided into MARSI and non-MARSI groups. Univariate analysis was performed to screen for associated variables, and logistic regression analysis was used to identify independent risk factors for PICC-MARSI.
Of all 340 patients enrolled, 33 (9.7%) developed PICC-MARSI, including skin tear (8, 24.2%), tension injury (5, 15.2%), irritant contact dermatitis (10, 30.3%), allergic dermatitis (7, 21.2%) and maceration (3, 9.1%). Multivariable analysis showed that age (OR=1.058, p=0.001, 95% CI 1.023-1.094), wet skin (OR=4.873, p=0.003, 95% CI 1.728-13.742), dry skin (OR=6.247, p<0.0001, 95% CI 2.239-17.431), oedema (OR=3.302, p=0.008, 95% CI 1.365-7.985), allergy history (OR=6.044, p=0.001, 95% CI 2.040-17.906), dressing type (OR=3.827, p=0.003, 95% CI 1.595-9.185), body mass index (BMI) <18.5 (OR=4.271, p=0.015, 95% CI 1.327-13.742) and BMI 25-30 (OR=2.946, p=0.027, 95% CI 1.131-7.678) were independent risk factors for PICC-MARSI.
Proper catheter maintenance and appropriate dressing selection are crucial for the prevention of this condition.
本研究旨在探讨癌症患者经外周静脉置入中心静脉导管(PICC)部位发生的与医用黏胶相关的皮肤损伤(MARSI)的发生率和相关因素。
在中国深圳的一家三级医院进行了一项前瞻性观察性队列研究。
这是在中国深圳的一家三级医院进行的单中心研究。
采用便利抽样法,共选取 2022 年 1 月至 2023 年 6 月期间的 340 例癌症合并 PICC 置管患者。
记录了可能与 PICC 相关的 MARSI(PICC-MARSI)相关的因素,包括患者人口统计学资料以及导管置管和维护情况。患者分为 MARSI 组和非 MARSI 组。采用单因素分析筛选相关变量,采用 logistic 回归分析确定 PICC-MARSI 的独立危险因素。
在所有纳入的 340 例患者中,有 33 例(9.7%)发生了 PICC-MARSI,包括皮肤撕裂伤(8 例,24.2%)、张力性损伤(5 例,15.2%)、刺激性接触性皮炎(10 例,30.3%)、过敏性皮炎(7 例,21.2%)和浸渍(3 例,9.1%)。多因素分析显示,年龄(OR=1.058,p=0.001,95%CI 1.023-1.094)、潮湿皮肤(OR=4.873,p=0.003,95%CI 1.728-13.742)、干燥皮肤(OR=6.247,p<0.0001,95%CI 2.239-17.431)、水肿(OR=3.302,p=0.008,95%CI 1.365-7.985)、过敏史(OR=6.044,p=0.001,95%CI 2.040-17.906)、敷料类型(OR=3.827,p=0.003,95%CI 1.595-9.185)、BMI<18.5(OR=4.271,p=0.015,95%CI 1.327-13.742)和 BMI 25-30(OR=2.946,p=0.027,95%CI 1.131-7.678)是 PICC-MARSI 的独立危险因素。
适当的导管维护和合适的敷料选择对于预防这种情况至关重要。