Precurved non-tunnelled catheters for haemodialysis are comparable in terms of infections and malfunction as compared to tunnelled catheters: A retrospective cohort study.
Aged
Catheter-Related Infections
/ diagnosis
Catheterization, Central Venous
/ adverse effects
Catheters, Indwelling
Central Venous Catheters
Equipment Design
Equipment Failure
Female
Humans
Male
Middle Aged
Netherlands
Renal Dialysis
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
Haemodialysis
catheter
complications
infections
vascular access
Journal
The journal of vascular access
ISSN: 1724-6032
Titre abrégé: J Vasc Access
Pays: United States
ID NLM: 100940729
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
pubmed:
23
10
2018
medline:
14
6
2019
entrez:
23
10
2018
Statut:
ppublish
Résumé
The main limitations of central venous catheters for haemodialysis access are infections and catheter malfunction. Our objective was to assess whether precurved non-tunnelled central venous catheters are comparable to tunnelled central venous catheters in terms of infection and catheter malfunction and to assess whether precurved non-tunnelled catheters are superior to straight catheters. In this retrospective, observational cohort study, adult patients in whom a central venous catheter for haemodialysis was inserted between 2012 and 2016 were included. The primary endpoint was a combined endpoint consisting of the first occurrence of either an infection or catheter malfunction. The secondary endpoint was a combined endpoint of the removal of the central venous catheter due to either an infection or a catheter malfunction. Using multivariable analysis, cause-specific hazard ratios for endpoints were calculated for tunnelled catheter versus precurved non-tunnelled catheter, tunnelled catheter versus non-tunnelled catheter, and precurved versus straight non-tunnelled catheter. A total of 1603 patients were included. No difference in reaching the primary endpoint was seen between tunnelled catheters, compared to precurved non-tunnelled catheters (hazard ratio, 0.91; 95% confidence interval, 0.70-1.19, p = 0.48). Tunnelled catheters were removed less often, compared to precurved non-tunnelled catheters (hazard ratio, 0.65; 95% confidence interval, 0.46-0.93; p = 0.02). A trend for less infections and catheter malfunctions was seen in precurved jugular non-tunnelled catheters compared to straight non-tunnelled catheters (hazard ratio, 0.60; 95% confidence interval, 0.24-1.50; p = 0.28) and were removed less often (hazard ratio, 0.41; 95% confidence interval, 0.18-0.93; p = 0.03). Tunnelled central venous catheters and precurved non-tunnelled central venous catheters showed no difference in reaching the combined endpoint of catheter-related infections and catheter malfunction. Tunnelled catheters get removed less often because of infection/malfunction than precurved non-tunnelled catheters.
Sections du résumé
BACKGROUND
BACKGROUND
The main limitations of central venous catheters for haemodialysis access are infections and catheter malfunction. Our objective was to assess whether precurved non-tunnelled central venous catheters are comparable to tunnelled central venous catheters in terms of infection and catheter malfunction and to assess whether precurved non-tunnelled catheters are superior to straight catheters.
MATERIALS AND METHODS
METHODS
In this retrospective, observational cohort study, adult patients in whom a central venous catheter for haemodialysis was inserted between 2012 and 2016 were included. The primary endpoint was a combined endpoint consisting of the first occurrence of either an infection or catheter malfunction. The secondary endpoint was a combined endpoint of the removal of the central venous catheter due to either an infection or a catheter malfunction. Using multivariable analysis, cause-specific hazard ratios for endpoints were calculated for tunnelled catheter versus precurved non-tunnelled catheter, tunnelled catheter versus non-tunnelled catheter, and precurved versus straight non-tunnelled catheter.
RESULTS
RESULTS
A total of 1603 patients were included. No difference in reaching the primary endpoint was seen between tunnelled catheters, compared to precurved non-tunnelled catheters (hazard ratio, 0.91; 95% confidence interval, 0.70-1.19, p = 0.48). Tunnelled catheters were removed less often, compared to precurved non-tunnelled catheters (hazard ratio, 0.65; 95% confidence interval, 0.46-0.93; p = 0.02). A trend for less infections and catheter malfunctions was seen in precurved jugular non-tunnelled catheters compared to straight non-tunnelled catheters (hazard ratio, 0.60; 95% confidence interval, 0.24-1.50; p = 0.28) and were removed less often (hazard ratio, 0.41; 95% confidence interval, 0.18-0.93; p = 0.03).
CONCLUSION
CONCLUSIONS
Tunnelled central venous catheters and precurved non-tunnelled central venous catheters showed no difference in reaching the combined endpoint of catheter-related infections and catheter malfunction. Tunnelled catheters get removed less often because of infection/malfunction than precurved non-tunnelled catheters.
Identifiants
pubmed: 30345873
doi: 10.1177/1129729818805954
pmc: PMC6506901
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
307-312Investigateurs
J A Bijlsma
(JA)
K E A van der Bogt
(KEA)
A van de Brug
(A)
C E Douma
(CE)
E J Hoorn
(EJ)
D H T IJpelaar
(DHT)
M J Krol-van Straaten
(MJ)
K W Mui
(KW)
J H M Tordoir
(JHM)
H H Vincent
(HH)
N Zonnebeld
(N)
Références
Kidney Int. 2000 Dec;58(6):2543-5
pubmed: 11115089
J Vasc Interv Radiol. 2001 Apr;12(4):431-5
pubmed: 11287528
Nephrol Dial Transplant. 2001 Nov;16(11):2194-200
pubmed: 11682667
Semin Dial. 2001 Nov-Dec;14(6):432-5
pubmed: 11851928
Nephrol Dial Transplant. 2004 Mar;19(3):670-7
pubmed: 14767025
Cardiovasc Intervent Radiol. 2005 Jan-Feb;28(1):23-9
pubmed: 15602643
Nephrol Dial Transplant. 2008 Mar;23(3):977-83
pubmed: 17984107
Blood Purif. 2009;28(1):21-8
pubmed: 19325236
Clin Infect Dis. 2009 Jul 1;49(1):1-45
pubmed: 19489710
Nephrol Dial Transplant. 2010 May;25(5):1596-604
pubmed: 20054025
Crit Care Med. 2012 Aug;40(8):2479-85
pubmed: 22809915
Am J Kidney Dis. 2013 Jan;61(1):123-30
pubmed: 23159234
Am J Kidney Dis. 2014 Dec;64(6):902-8
pubmed: 24713222
Nephrol Dial Transplant. 2014 Oct;29(10):1956-64
pubmed: 25061126
Eur J Vasc Endovasc Surg. 2017 Oct;54(4):513-522
pubmed: 28843984
NDT Plus. 2010 Jun;3(3):234-246
pubmed: 30792802
Am J Kidney Dis. 1996 Sep;28(3):428-36
pubmed: 8804243