Long-term central venous catheter use among cancer patients in administrative claims data.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6101-6101
Author(s):  
Allison Nicole Lipitz Snyderman ◽  
Kent Sepkowitz ◽  
Elena B. Elkin ◽  
Laura C Pinheiro ◽  
Crystal Son ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Claims Data ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Population Based ◽  
Multivariable Logistic Regression Analysis ◽  
Administrative Claims ◽  
Central Venous

6101 Background: This study’s objective was to examine administrative claims data’s capacity to serve as a surveillance tool for long-term catheter use and related bloodstream infections among cancer patients. Population-based estimates and efforts to track catheter use and infections for this group are limited. As such, we sought to explore catheter use documentation using a cohort of colorectal cancer patients. Methods: We performed a retrospective analysis using the population-based SEER-Medicare dataset for patients 66 years or older diagnosed with colorectal cancer in 2005-2007 (n = 54,870). Insertions and removals of long-term central venous catheters (i.e., tunneled, ports/pumps, peripherally inserted central catheter [PICCs]) were identified by billing codes within 2 years of diagnosis. Factors associated with catheter use were identified in multivariable logistic regression analysis. Results: Findings were consistent with clinical expectations. A total of 11,775 patients (21%) had at least one documented long-term catheter insertion within 2 years of diagnosis, 19% within 6 months. Of those with catheters, approximately 25% had more than one insertion. Sixty-eight percent had at least one port/pump, 8% at least one tunneled catheter, and 33% at least one PICC. Seventy-four percent of catheterized patients had IV chemotherapy. Of patients stages I, II, III, and IV, 10%, 18%, 37%, and 39% had catheters, respectively. Adjusted for other factors, patients with catheters were significantly more likely to be younger, female, black (vs. white), and have comorbidities (vs. none documented in year prior to diagnosis), compared to patients without catheters. By the end of the study, 34% of patients with ports/pumps had documented removal and 42% died (for patients with tunneled catheters, 28% and 52%, respectively). Conclusions: Findings support the use of claims data to capture long-term catheter use in cancer patients, providing a foundation for exploration of its capacity to capture infections. Given extensive documented catheter use (21%), infections may be a significant problem. Claims data may offer a low-burden method for surveillance and study, aiding the development of targeted initiatives.

scholarly journals Care of Peripheral Venous Catheter Sites: Advantages of Transparent Film Dressings Over Tape and Gauze

2014 ◽  
Vol 19 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Stéphanie F. Bernatchez
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
The United States ◽  
Central Venous ◽  
Term Care ◽  
Peripheral Venous Catheter ◽  
Care Facilities ◽  
Review Current ◽  
Peripheral Venous Line

AbstractPeripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.

Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis

2018 ◽  
Vol 27 (2) ◽  
pp. 407-421 ◽  
Author(s):  
Ana Cristina Carvalho da Costa ◽  
Jéssica Marques Ribeiro ◽  
Christiane Inocêncio Vasques ◽  
Graziela De Luca Canto ◽  
André Luís Porporatti ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Venous Catheter ◽  
Central Venous

scholarly journals Diagnosis and management of catheter-related bloodstream infections in patients on home parenteral nutrition

2019 ◽  
Vol 11 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Ashley Bond ◽  
Paul Chadwick ◽  
Trevor R Smith ◽  
Jeremy M D Nightingale ◽  
Simon Lal
Keyword(s):  
Parenteral Nutrition ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Nutrition Support ◽  
Central Venous ◽  
Short Term ◽  
Qualitative And Quantitative ◽  
Central Venous Catheter Removal ◽  
Support Team

Catheter-related bloodstream infections (CRBSIs) commonly arise from a parenteral nutrition catheter hub. A target for a Nutrition Support Team is to have a CRBSI rate of less than 1 per 1000. The diagnosis of CRBSI is suspected clinically by a temperature shortly after setting up a feed, general malaise or raised blood inflammatory markers. It is confirmed by qualitative and quantitative blood cultures from the catheter and peripherally. Treatment of inpatients may involve central venous catheter removal and antibiotics for patients needing short-term parenteral nutrition, but catheter salvage is generally recommended for patients needing long-term parenteral nutrition, where appropriate.

Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

1999 ◽  
Vol 20 (7) ◽  
pp. 494-498 ◽  
Author(s):  
Pascal Astagneau ◽  
Sylvie Maugat ◽  
Tuan Tran-Minh ◽  
Marie-Cécile Douard ◽  
Pascale Longuet ◽  
...  
Keyword(s):  
Cohort Study ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous ◽  
Hiv Patients ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Hiv And Cancer

Objectives:To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.Design:Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.Setting:Services of infectious diseases and oncology of 12 university hospitals in Paris, France.Participants:In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.Results:Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.Conclusions:Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

Blood Products: A Significant Risk Factor for Long-Term Catheter-Related Bloodstream Infections in Cancer Patients

2001 ◽  
Vol 22 (03) ◽  
pp. 165-166 ◽  
Author(s):  
Hend A. Hanna ◽  
Issam Raad
Keyword(s):  
Risk Factor ◽  
Cancer Patients ◽  
Randomized Study ◽  
Significant Risk ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Significant Risk Factor ◽  
Recent Analysis ◽  
Blood Products ◽  
Central Venous

Abstract Data obtained from a previous prospective randomized study in cancer patients conducted at our institution were analyzed to investigate risk factors for catheter-related (CR) bloodstream infections (BSIs). Our recent analysis showed that the administration of blood products through central venous catheters was a risk factor for CR BSI, whereas thrombocytopenia during catheterization may have provided protection against CR BSI, as did central venous catheter insertion under maximal sterile barrier precautions.

scholarly journals Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic

2015 ◽  
Vol 28 (4) ◽  
pp. 474
Author(s):  
Jose Manuel Martinez ◽  
Luís Leite ◽  
Daniela França ◽  
Rita Capela ◽  
Luísa Viterbo ◽  
...  
Keyword(s):  
Relative Risk ◽  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Mechanical Valve ◽  
Venous Catheter ◽  
Positive Pressure ◽  
Control Group ◽  
Study Group ◽  
Central Venous

<p><strong>Introduction:</strong> The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter.<br /><strong>Material and Methods:</strong> This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study.<br /><strong>Results:</strong> A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p &lt; 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p &lt; 0.014]. No significant difference (p &gt; 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (&lt; 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)].<br /><strong>Conclusions:</strong> The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.</p>

scholarly journals Impact of Catheter Management on Clinical Outcome in Adult Cancer Patients With Gram-Negative Bacteremia

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Johny Fares ◽  
Melissa Khalil ◽  
Anne-Marie Chaftari ◽  
Ray Hachem ◽  
Ying Jiang ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Mucosal Barrier ◽  
Central Venous ◽  
Gram Negative ◽  
Central Venous Catheter Removal ◽  
Mucosal Barrier Injury

Abstract Objective Gram-negative organisms have become a major etiology of bloodstream infections. We evaluated the effect of central venous catheter management on cancer patients with gram-negative bloodstream infections. Method We retrospectively identified patients older than 14 years with central venous catheters who were diagnosed with gram-negative bloodstream infections to determine the effect of catheter management on outcome. Patients were divided into 3 groups: Group 1 included patients with central line-associated bloodstream infections (CLABSI) without mucosal barrier injury and those whose infection met the criteria for catheter-related bloodstream infection; group 2 included patients with CLABSI with mucosal barrier injury who did not meet the criteria for catheter-related bloodstream infection; and group 3 included patients with non-CLABSI. Results The study included 300 patients, with 100 patients in each group. Only in group 1 was central venous catheter removal within 2 days of bloodstream infection significantly associated with a higher rate of microbiologic resolution at 4 days compared to delayed central venous catheter removal (3–5 days) or retention (98% vs 82%, P = .006) and a lower overall mortality rate at 3-month follow-up (3% vs 19%, P = .01). Both associations persisted in multivariate analyses (P = .018 and P = .016, respectively). Conclusions Central venous catheter removal within 2 days of the onset of gram-negative bloodstream infections significantly improved the infectious outcome and overall mortality of adult cancer patients with catheter-related bloodstream infections and CLABSI without mucosal barrier injury.

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