Risk factors for catheter related thrombosis during outpatient parenteral antimicrobial therapy.


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:
Sep 2022
Historique:
pubmed: 14 4 2021
medline: 14 9 2022
entrez: 13 4 2021
Statut: ppublish

Résumé

Outpatient parenteral antimicrobial therapy (OPAT) delivery using peripherally inserted central catheters is associated with a risk of catheter related thrombosis (CRT). Individualised preventative interventions may reduce this occurrence, however patient selection is hampered by a lack of understanding of risk factors. We aimed to identify patient, infection or treatment related risk factors for CRT in the OPAT setting. Retrospective case control study (1:3 matching) within OPAT services at two tertiary hospitals within Australia. Over a 2 year period, encompassing OPAT delivery to 1803 patients, there were 19 cases of CRT, giving a prevalence of 1.1% and incidence of 0.58/1000 catheter days. Amongst the cases of CRT, there were nine (47%) unplanned readmissions and two (11%) pulmonary emboli. Compared to controls, cases had a higher frequency of malposition of the catheter tip (4/19 (21%) vs 0/57 (0%), Although CRTs during OPAT are infrequent, they often have clinically significant sequelae. Identification of modifiable vascular access related predictors of CRT should assist with patient risk stratification and guide risk reduction strategies.

Sections du résumé

BACKGROUND UNASSIGNED
Outpatient parenteral antimicrobial therapy (OPAT) delivery using peripherally inserted central catheters is associated with a risk of catheter related thrombosis (CRT). Individualised preventative interventions may reduce this occurrence, however patient selection is hampered by a lack of understanding of risk factors. We aimed to identify patient, infection or treatment related risk factors for CRT in the OPAT setting.
METHODS UNASSIGNED
Retrospective case control study (1:3 matching) within OPAT services at two tertiary hospitals within Australia.
RESULTS UNASSIGNED
Over a 2 year period, encompassing OPAT delivery to 1803 patients, there were 19 cases of CRT, giving a prevalence of 1.1% and incidence of 0.58/1000 catheter days. Amongst the cases of CRT, there were nine (47%) unplanned readmissions and two (11%) pulmonary emboli. Compared to controls, cases had a higher frequency of malposition of the catheter tip (4/19 (21%) vs 0/57 (0%),
CONCLUSIONS UNASSIGNED
Although CRTs during OPAT are infrequent, they often have clinically significant sequelae. Identification of modifiable vascular access related predictors of CRT should assist with patient risk stratification and guide risk reduction strategies.

Identifiants

pubmed: 33845663
doi: 10.1177/11297298211009361
doi:

Substances chimiques

Anti-Bacterial Agents 0
Anti-Infective Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

738-742

Auteurs

Paul R Ingram (PR)

School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, WA, Australia.
Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA, Australia.
Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia.

Sinead Kilgarriff (S)

Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia.

Michael Grzelak (M)

Royal Perth Hospital, Perth, WA, Australia.

Gavin Jackson (G)

Peripherally Inserted Central Catheter service, Fiona Stanley Hospital, Murdoch, WA, Australia.

Peter Carr (P)

School of Nursing and Midwifery, National University of Ireland, Galway, Ireland.
Menzies Health Institute, Griffith University, Queensland, Australia.

Peter Boan (P)

Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia.

Claire Italiano (C)

Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA, Australia.

John Dyer (J)

Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia.

Edward Raby (E)

Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA, Australia.
Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia.

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Classifications MeSH