Clinical outcomes of peripherally inserted central catheters in patients with gastroenterological diseases: Report of a 9-year experience.

IF 1.7 3区医学 Q3 PERIPHERAL VASCULAR DISEASE

Journal of Vascular Access Pub Date : 2025-09-01 Epub Date: 2024-09-26 DOI:10.1177/11297298241279063

Takehito Yamamoto, Yoichiro Uchida, Jo Yano, Reo Nakano, Yoshiki Oshimo, Takashi Fujimoto, Koji Hisano, Kenzo Nakano, Takayuki Kawai, Yoshihisa Okuchi, Kohta Iguchi, Eiji Tanaka, Meiki Fukuda, Kojiro Taura, Hiroaki Terajima

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引用次数: 0

Abstract

Background: Peripherally inserted central catheters (PICCs) are safe and useful alternatives to centrally inserted central catheters (CICCs). Several studies have investigated the effectiveness and safety of PICCs; however, few have focused on their use in patients with gastroenterological diseases. In the present study, we evaluated the outcomes of patients with gastroenterological diseases who received PICCs and identified the risk factors associated with central line-associated blood stream infection (CLABSI).

Methods: We retrospectively examined hospitalized patients at our institution who received PICCs between 2015 and 2023. We evaluated the data on their clinical characteristics, complications, and outcomes. Furthermore, we investigated the risk factors for CLABSIs.

Results: A total of 405 patients were included (262 men and 143 women). The median age was 71 (range, 15-94) years. The vessels were inserted in the basilic, cephalic, and brachial veins in 366 (90%), 22 (6%), and 17 (4%) patients, respectively. The median procedure time was 32 [6-149] min. The median dwell time was 16 [0-188] days. CLABSI, catheter occlusions, phlebitis, and exit-site skin infection occurred in 14 (3.5%; 1.77/1000 catheter days), 6 (1.5%; 0.76/1000 catheter days), 3 (0.7%; 0.38/1000 catheter days), and 1 (0.2%; 0.13/1000 catheter days) patients, respectively. There was no case of deep vein thrombosis or pulmonary thrombosis due to PICC placement. Multivariate analysis performed using a Cox's proportional hazard regression model revealed that patients with gastroenterological malignancies had an independently higher risk for CLABSIs (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.05-10.05, p = 0.041) and that older age (⩾70 years) tended to be associated with CLABSIs (OR: 3.61, 95% CI: 0.98-13.32, p = 0.054).

Conclusions: Gastroenterological malignancies and older age were associated with a higher risk of CLABSIs. Rigorous catheter management is crucial for preventing complications, particularly in vulnerable patient subgroups.

查看原文本刊更多论文

胃肠病患者使用外周置入中央导管的临床效果：9 年临床经验报告。

背景：外周置入中心导管（PICC）是中心置入中心导管（CICC）的安全而有用的替代品。已有多项研究调查了 PICC 的有效性和安全性，但很少有研究关注其在胃肠病患者中的应用。在本研究中，我们评估了接受 PICC 的胃肠病患者的治疗效果，并确定了与中心管路相关血流感染（CLABSI）有关的风险因素：我们回顾性研究了本院在2015年至2023年间接受PICC的住院患者。我们评估了他们的临床特征、并发症和预后数据。此外，我们还调查了 CLABSIs 的风险因素：共纳入 405 名患者（男性 262 人，女性 143 人）。中位年龄为 71 岁（15-94 岁）。分别有366名（90%）、22名（6%）和17名（4%）患者的血管插入了基底静脉、头静脉和肱静脉。手术时间中位数为 32 [6-149] 分钟。中位停留时间为 16 [0-188] 天。发生 CLABSI、导管闭塞、静脉炎和出口皮肤感染的患者分别为 14 例（3.5%；1.77/1000 个导管日）、6 例（1.5%；0.76/1000 个导管日）、3 例（0.7%；0.38/1000 个导管日）和 1 例（0.2%；0.13/1000 个导管日）。没有一例患者因置入 PICC 而导致深静脉血栓或肺血栓形成。使用Cox比例危险回归模型进行的多变量分析显示，患有胃肠道恶性肿瘤的患者发生CLABSI的风险更高（比值比[OR]：3.25，95% 置信区间[CI]：1.05-10.05，P = 0.041），年龄越大（70岁以上）发生CLABSI的风险越高（比值比[OR]：3.61，95% 置信区间[CI]：0.98-13.32，P = 0.054）：结论：胃肠道恶性肿瘤和高龄与较高的 CLABSIs 风险有关。严格的导管管理对于预防并发症至关重要，尤其是在易感患者亚群中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Access 医学-外周血管病

CiteScore

3.40

自引率

31.60%

发文量

181

审稿时长

6-12 weeks

期刊介绍： The Journal of Vascular Access (JVA) is issued six times per year; it considers the publication of original manuscripts dealing with clinical and laboratory investigations in the fast growing field of vascular access. In addition reviews, case reports and clinical trials are welcome, as well as papers dedicated to more practical aspects covering new devices and techniques. All contributions, coming from all over the world, undergo the peer-review process. The Journal of Vascular Access is divided into independent sections, each led by Editors of the highest scientific level: • Dialysis • Oncology • Interventional radiology • Nutrition • Nursing • Intensive care Correspondence related to published papers is also welcome.