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Title: Five-year outcome of peripherally inserted central catheters in adults: A separated infectious and thrombotic complications analysis
Authors: González López, Samuel 
Jiménez, Pedro
Saavedra Santana, Pedro 
MacÍas, Desiré
Loza, Ana
León, Cristóbal
López, Magdalena
Pallejá, Elena
Hernández Socorro, Carmen Rosa 
Ruiz Santana, Sergio 
UNESCO Clasification: 32 Ciencias médicas
3201 Ciencias clínicas
3202 Epidemologia
Keywords: Catheter-related infections
Infectious complications
Thrombotic complications
Issue Date: 2021
Journal: Infection Control and Hospital Epidemiology 
Abstract: Objective: To assess infectious and thrombotic complications of peripherally inserted central catheters (PICCs) in adults. Design: A 5-year prospective cohort study. Setting: Tertiary-care teaching hospital in Seville, Spain. Patients: Adult patients undergoing PICC insertion. Methods: Catheter-associated bloodstream infection (CABSI) including catheter-related bloodstream infection (CRBSI), primary bacteremia (PB), and upper extremity deep vein thrombosis (UEDVT) were recorded. Independent predictors of complications were assessed by multivariate analysis. Results: In total, 1,142 PICCs were inserted, with 153,191 catheter days (median, 79). Complications included 66 cases of CABSI (5.78%; 0.43‰ catheter days), 38 cases of CRBSI (3.33%; 0.25‰ catheter days), 28 cases of PB (2.45%; 0.18‰ catheter days), and 23 cases of UEDVT (2.01%; 0.15‰ catheter days). The median times to infection were 24, 41, and 60 days for CRBSI, PB, and UEDVT, respectively. Parenteral nutrition (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.77-6.52) and admission to the hematology ward (OR, 4.90; 95% CI, 2.25-10.71) were independently associated with CRBSI and PB, respectively. Admission to the hematology ward (OR, 12.46; 95% CI, 2.49-62.50) or to the oncology ward (OR, 7.89; 95% CI, 1.77-35.16) was independently associated with UEDVT. The crude mortality rate was 24.8%. Only 2 patients died of complications. Conclusions: PICCs showed a low rate of thrombotic and infectious complications. Compared to PB, CRBSI showed significantly different risk factors, a higher incidence density per catheter days, and a shorter median time to infection. Separate analyses of CRBSI and PB are more specific and clinically useful when analyzing infectious complications.
ISSN: 0899-823X
DOI: 10.1017/ice.2020.1300
Source: Infection Control and Hospital Epidemiology [ISSN 0899-823X], v. 42 (7), p. 833-841, (Julio 2021)
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