Catheter-Related Infection in Uncuffed, Non-Tunneled Dual-Lumen Catheters: Incidence and Risk Factors by Internal Jugular Versus Femoral Site in a Retrospective Cohort.

Abstract

Background: Uncuffed, non-tunneled dual-lumen catheters are often required for kidney replacement therapy (KRT), but catheter-related bloodstream infections (CRBSIs) remain a serious complication. Whether the jugular site poses a lower CRBSI risk than the femoral site is unclear.

Methods: This retrospective cohort study analyzed patients with uncuffed, non-tunneled dual-lumen catheters. CRBSI incidence, catheter dwelling time, and mortality rates were compared between jugular and femoral sites. Regression analyses identified CRBSI risk factors.

Results: A total of 572 patients were included in the study. The incidence proportion of CRBSI was 3.5% in both the femoral and jugular groups (10 of 286 patients in each group; p = 1.0). The incidence rates of CRBSI were 1.7 and 0.9 per 1000 patient-days for the femoral and jugular sites, respectively (p = 0.154). The median catheter dwelling time was significantly longer for jugular catheters (25 days) compared to femoral catheters (12 days; p < 0.001). The 30-day incidence proportion of death at the jugular site was significantly lower than at the femoral site (0.105 vs. 0.608, p < 0.001). Pre-existing cerebrovascular disease and congestive heart failure were identified as significant risk factors for CRBSI.

Conclusion: For uncuffed, non-tunneled dual-lumen catheters used for dialysis vascular access, the jugular insertion site does not demonstrate a reduced risk of CRBSI compared to the femoral site. However, jugular catheter placement is associated with a longer dwelling time and a lower mortality rate.