Lo Cascio Alessio, Bozzetti Mattia, Napolitano Daniele, Dabbene Marcella, Lunetto Leonardo, Latina Roberto, Mancin Stefano, Sguanci Marco, Piredda Michela
La Maddalena Cancer Center, Via San Lorenzo 312, 90146 Palermo, Italy.
Azienda Socio Sanitaria Territoriale di Cremona, 26100 Cremona, Italy.
Cancers (Basel). 2025 Mar 31;17(7):1182. doi: 10.3390/cancers17071182.
Peripherally Inserted Central Catheters (PICCs) and midline catheters are crucial for chemotherapy and supportive care in cancer patients. Their use requires ongoing monitoring to prevent late complications such as infections, dislodgements, and replacements. The COVID-19 pandemic challenged healthcare systems, potentially increasing these complications due to reduced outpatient services and limited specialized personnel.
This study compared the incidence of late complications associated with PICCs and midline catheters in cancer patients during and after the COVID-19 pandemic.
A retrospective observational study was conducted at a Cancer Center in Italy from March 2020 to April 2024. Catheter-related complications were divided into two cohorts: during the pandemic (March 2020-March 2022) and post-pandemic (April 2022-April 2024). The primary outcome was the incidence of late complications requiring device removal, categorized as infections, dislodgements, and replacements. Statistical analyses included the Chi-squared test for categorical variables and the Kruskal-Wallis test for continuous variables.
Of 4104 PICC and midline catheter placements, 2291 removals were recorded, with 550 (24%) due to late complications-404 during the pandemic and 146 post-pandemic ( < 0.001). Suspected infections were the most frequent complication, significantly higher during the pandemic ( < 0.001). Dislodgements and replacements also decreased markedly post-pandemic. Limited outpatient services and disrupted healthcare workflows likely contributed to higher complication rates during the pandemic.
The COVID-19 pandemic negatively impacted catheter management in cancer patients, increasing late complications. The post-pandemic decline highlights the importance of consistent care, infection prevention, remote monitoring, and stronger healthcare resilience to reduce risks in future crises.
外周静脉置入中心静脉导管（PICC）和中线导管对于癌症患者的化疗及支持性治疗至关重要。其使用需要持续监测以预防诸如感染、移位和更换等晚期并发症。新冠疫情给医疗系统带来了挑战，由于门诊服务减少和专业人员有限，这些并发症可能会增加。
本研究比较了新冠疫情期间及之后癌症患者中与PICC和中线导管相关的晚期并发症发生率。
2020年3月至2024年4月在意大利一家癌症中心进行了一项回顾性观察研究。导管相关并发症分为两个队列：疫情期间（2020年3月至2022年3月）和疫情后（2022年4月至2024年4月）。主要结局是需要移除装置的晚期并发症发生率，分为感染、移位和更换。统计分析包括分类变量的卡方检验和连续变量的克鲁斯卡尔-沃利斯检验。
在4104次PICC和中线导管置入中，记录了2291次移除，其中550次（24%）是由于晚期并发症——疫情期间404次，疫情后146次（<0.001）。疑似感染是最常见的并发症，在疫情期间显著更高（<0.001）。疫情后移位和更换也明显减少。门诊服务有限和医疗工作流程中断可能导致疫情期间并发症发生率更高。
新冠疫情对癌症患者的导管管理产生了负面影响，增加了晚期并发症。疫情后并发症发生率的下降凸显了持续护理、感染预防、远程监测以及更强的医疗复原力对于降低未来危机风险的重要性。
