Risk factors for catheter-related infections in neck tumor patients undergoing chemotherapy through peripherally inserted central catheters.

Abstract

Objective: To investigate the risk factors for catheter-related infections (CRI) in patients undergoing chemotherapy through tunneled peripherally inserted central catheters (PICCs) following neck tumor lymph node dissection. To provide evidence for clinical intervention strategies.

Methods: A retrospective review was conducted on the medical records from 495 patients who underwent tunneled PICC placement for chemotherapy after neck tumor lymph node dissection. Patients were divided into a CRI group (n=55) and a non-CRI group (n=440). The incidence of CRI, infection type, and pathogen distribution were statistically analyzed. Multivariate logistic regression was employed to identify independent risk factors. A logistic regression-based predictive model was established and its performance was evaluated.

Results: Among the 495 patients, the incidence of CRI was 11.11% (55/495), with exit-site infections being the predominant type (25 cases, 45.45%). A total of 11 pathogenic strains were isolated. Multivariate logistic regression analysis revealed that PICC indwelling duration >30 days, catheter displacement, concomitant diabetes mellitus, and white blood cell count ≤3.0×10⁹/L were independent risk factors for CRI (all P<0.05). The area under the curve (AUC) for the logistic regression model for predicting CRI efficacy was 0.896 [95% CI, 0.845, 0.947], with a sensitivity of 91.0% and a specificity of 79.0%. Calibration curves demonstrated good agreement with the ideal predictions.

Conclusions: Patients undergoing chemotherapy through tunneled PICC after neck tumor lymph node dissection exhibit a relatively high incidence of CRI. Clinicians should implement targeted interventions for patients with prolonged catheterization, catheter displacement, diabetes mellitus, and leukopenia to reduce the incidence of CRI and improve patient outcome.