成人血液恶性肿瘤患者与外周置入中心静脉导管相关的并发症。

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Malaysian Journal of Medical Sciences Pub Date : 2024-04-01 Epub Date: 2024-04-23 DOI:10.21315/mjms2024.31.2.6
Kee Wei Lee, Chin Sum Cheong, Gan Gin Gin
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引用次数: 0

摘要

背景:外周置入中心静脉导管(PICC)广泛应用于血液恶性肿瘤患者,因为患者需要长时间的静脉治疗。然而,随着 PICC 使用量的不断增加,感染和血栓形成等并发症也层出不穷,导致住院时间延长和发病率增加。本研究旨在确定血液恶性肿瘤患者中 PICC 相关并发症的发生率和相关因素:这项前瞻性队列研究在一家学术机构进行。纳入标准包括所有新插入 PICC 的成年血液恶性肿瘤患者。对患者进行至少 60 天的观察,以评估与 PICC 相关的感染和血栓形成以及机械并发症的发生率:结果:85 名患者共植入了 119 根 PICC。结果:85 名患者共植入了 119 个 PICC,其中一半以上被诊断为淋巴瘤(55.0%)。中位停留时间为 61 天(四分位间范围:98 天)。PICC 相关并发症的发生率为 58.0%(每千导管日 6.9 例)。具体来说,43 例 PICC(36.1%,每千个导管日 4.3 例)出现感染并发症,25 例(21.1%,每千个导管日 2.5 例)出现机械并发症,1 例(0.8%,每千个导管日 0.1 例)出现血栓并发症。此外,急性白血病的潜在诊断与 PICC 相关感染的较高发生率明显相关:我们的研究显示,与其他研究结果相比,患有血液系统恶性肿瘤的成人患者发生 PICC 相关并发症的几率更高。值得注意的是,患有潜在急性白血病的患者发生 PICC 相关感染的几率更高。这些发现强调了采取适当的干预措施和进行彻底的根本原因分析以有效缓解这种并发症和改善患者预后的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Peripherally Inserted Central Venous Catheter-Related Complications in Adult Patients with Haematological Malignancy.

Background: Peripherally inserted central venous catheters (PICC) are widely used in patients with haematological malignancies owing to the requirement for prolonged intravenous therapy. However, the growing use of PICCs has resulted in a multitude of complications such as infections and thrombosis, leading to prolonged hospitalisation periods and increased morbidity. This study aimed to determine the incidence of and factors associated with PICC-related complications in patients with haematological malignancies.

Methods: This prospective cohort study was conducted at a single academic institution. The inclusion criteria involved all adult patients with haematological malignancies who had newly inserted PICCs. The patients were observed for a minimum duration of 60 days to evaluate the incidence of PICC-related infections and thrombosis, as well as mechanical complications.

Results: A total of 119 PICCs were implanted in 85 patients. Among them, more than half of the patients were diagnosed with lymphoma (55.0%). The median dwell time was 61 days (interquartile range: 98 days). The incidence of PICC-related complications was 58.0% (6.9 per 1,000 catheter-days). Specifically, 43 PICCs (36.1%, 4.3 per 1,000 catheter-days) experienced infective complications, 25 (21.1%, 2.5 per 1,000 catheter-days) encountered mechanical complications and 1 (0.8%, 0.1 per 1,000 catheter-days) exhibited thrombotic complications. Furthermore, an underlying diagnosis of acute leukaemia was significantly associated with a higher incidence of PICC-related infections.

Conclusion: Our study revealed higher incidence rates of PICC-related complications in adult patients with haematological malignancies compared to the finding of other studies. Notably, patients with underlying acute leukaemia displayed a higher incidence of PICC-related infections. These findings underscore the importance of implementing appropriate interventions and conducting thorough root cause analyses to effectively mitigate this complication and improve patient outcomes.

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来源期刊
Malaysian Journal of Medical Sciences
Malaysian Journal of Medical Sciences MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.70
自引率
0.00%
发文量
89
审稿时长
9 weeks
期刊介绍: The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access, fully online journal that is published at least six times a year. The journal’s scope encompasses all aspects of medical sciences including biomedical, allied health, clinical and social sciences. We accept high quality papers from basic to translational research especially from low & middle income countries, as classified by the United Nations & World Bank (https://datahelpdesk.worldbank.org/knowledgebase/ articles/906519), with the aim that published research will benefit back the bottom billion population from these countries. Manuscripts submitted from developed or high income countries to MJMS must contain data and information that will benefit the socio-health and bio-medical sciences of these low and middle income countries. The MJMS editorial board consists of internationally regarded clinicians and scientists from low and middle income countries.
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