Taieb Julien, Pellerin Olivier, de Pouvourville Gérard, Massol Jacques, Jaskulski Séverine, Shepelev Julian, Gautier Laurène, Medina Patricia
Gastrointestinal Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, Université Paris-Cité, SIRIC CARPEM, Paris, France.
Assistance Publique Hôpitaux de Paris, Service de Radiologie Interventionnelle Vasculaire et Oncologique, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris, Paris, France.
Medicine (Baltimore). 2025 Jun 6;104(23):e42704. doi: 10.1097/MD.0000000000042704.
Data confirming parenteral nutrition (PN) as an independent risk factor for catheter-related infection (CRI) are scarce and not recent. This study aims to estimate the effect of PN on CRI in cancer patients after catheter placement. A retrospective cohort analysis of the French National Health Data System was conducted. A total of 5300 gastric, 5975 pancreatic, and 15,102 lung cancer patients with central venous catheter insertion between 2012 and 2016 were included. Potential confounders for CRI were evaluated using Poisson regression. Incidence rates (IRs) of CRI were calculated. Incidence rate ratio (IRR) was estimated to assess the effect of exposure to PN on infection occurrence in all patients and among patients receiving chemotherapy (CT). The independent risk factors found to be associated with CRI were age, sex, Charlson Comorbidity Index, PN, CT, metastasis, and history of infection. After adjustment, there was an increased risk of CRI in patients with versus without PN in gastric (IRR: 1.1165; 95% confidence interval [95% CI]: 1.0119-1.2319), pancreatic (IRR: 1.2071; 95% CI: 1.0985-1.3265), and lung cancer (IRR: 1.1850; 95% CI: 1.0832-1.2962). In patients who received PN, IRs of CRI were higher than in those who did not, for gastric (34.84% vs 29.69%, respectively; P = .0001), pancreatic (38.89% vs 28.58%, respectively; P < .0001), and lung (23.64% vs 22.13%, respectively; P = .0967) cancer cohorts. The results of this National administrative claims database analysis suggested that PN might be one of the independent risk factors for CRI. However, the risk was smaller than previously reported, regardless of whether the patient was receiving CT or not.
证实肠外营养（PN）是导管相关感染（CRI）独立危险因素的数据稀少且不新。本研究旨在评估PN对癌症患者置管后CRI的影响。对法国国家卫生数据系统进行了一项回顾性队列分析。纳入了2012年至2016年间共5300例胃癌、5975例胰腺癌和15102例肺癌且插入中心静脉导管的患者。使用泊松回归评估CRI的潜在混杂因素。计算CRI的发病率（IRs）。估计发病率比（IRR）以评估PN暴露对所有患者以及接受化疗（CT）患者感染发生的影响。发现与CRI相关的独立危险因素为年龄、性别、查尔森合并症指数、PN、CT、转移和感染史。调整后，胃癌患者中接受PN与未接受PN的患者相比，CRI风险增加（IRR：1.1165；95%置信区间[95%CI]：1.0119 - 1.2319），胰腺癌患者中（IRR：1.2071；95%CI：1.0985 - 1.3265），肺癌患者中（IRR：1.1850；95%CI：1.0832 - 1.2962）。在接受PN的患者中，胃癌队列（分别为34.84%对29.69%；P = 0.0001）、胰腺癌队列（分别为38.89%对28.58%；P < 0.0001）和肺癌队列（分别为23.64%对22.13%；P = 0.0967）的CRI发病率均高于未接受PN的患者。这项国家行政索赔数据库分析结果表明，PN可能是CRI的独立危险因素之一。然而，无论患者是否接受CT，该风险均小于先前报道的风险。
