Comparison of complications in midlines versus central venous catheters: Are midlines safer than central venous lines?

Autor: Teena Chopra, Sonia Gera, Aleena Saleem, Natasha Rana, Suganya Chandramohan, Maninder Kaur, Ammara Mushtaq, Amar Krishna, Malini Surapaneni, Bhagyashri Navalkele
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Catheterization
Central Venous
Michigan
Epidemiology
medicine.medical_treatment
Length of hospitalization
Bacteremia
030501 epidemiology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
Catheterization
Peripheral
medicine
Humans
Statistical analysis
In patient
030212 general & internal medicine
Aged
Retrospective Studies
Aged
80 and over
Venous Thrombosis
Cross Infection
Adult patients
business.industry
Health Policy
Incidence (epidemiology)
Incidence
Public Health
Environmental and Occupational Health
Retrospective cohort study
Tertiary care hospital
Middle Aged
Thrombophlebitis
equipment and supplies
Intensive Care Units
Infectious Diseases
Catheter-Related Infections
Female
0305 other medical science
business
Central venous catheter
Zdroj: American journal of infection control. 46(7)
ISSN: 1527-3296
Popis: With the rising use of midline catheters (MCs), validation of their safety is essential. Our study aimed to evaluate the incidence of bloodstream infections (BSIs) and other complications related to the use of MCs and central venous catheters (CVCs).A retrospective cohort study was performed at a tertiary care hospital in Detroit, Michigan, from March-September 2016. Adult patients with either MC or CVC were included. Outcomes assessed were catheter-related BSI (CRBSI), mechanical complications, hospital length of stay, readmission within 90 days of discharge (RA), and mortality. Statistical analysis was performed using SAS software.A total of 411 patients with MC and 282 patients with CVC were analyzed. More CRBSIs were seen in patients with CVC (10/282) than MC (1/411) (3.5% vs 0.2%, respectively; P = .0008). More mechanical complications were seen in patients with MC (2.6%) than CVC (0.3%; P = .03). Patients with CVC had a higher crude mortality (17.3% vs 5.3%; P .0001), RA (58% vs 35%; P ≤ .0001), line-related RA (2.8% vs 0.2%; P = .0041), and transfer to intensive care unit after line placement (9% vs 5%; P = .01). CVC was a significant exposure for a composite of mortality, CRBSI, mechanical issues, thrombosis, and readmission because of a line-related complication (odds ratio, 3.2; 95% confidence interval, 1.8-5.8).Our findings show use of MC is safer than CVC, but larger studies are needed to confirm our findings.
Databáze: OpenAIRE
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