Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

医学 外周穿刺中心静脉导管 导管 并发症 放射治疗 血栓形成 外科 逻辑回归 化疗 癌症 内科学
作者
Jun Xie,Ling Xu,Xiaomin Xu,Yunjuan Huang
出处
期刊:Journal of Clinical Nursing [Wiley]
卷期号:26 (23-24): 4726-4733 被引量:17
标识
DOI:10.1111/jocn.13825
摘要

Aims and objectives To identify whether patients with advanced cancers were at high risk of peripherall"y inserted central catheter‐related complications when treated with concurrent chemo‐radiotherapy. Background Peripherally inserted central catheters are widely used in chemotherapy. However, catheter usage may elevate the risks of infections and thrombosis. It is important to identify the patients with high risk of peripherally inserted central catheter‐related complications. To date, little is known about peripherally inserted central catheter‐related complications in patients with advanced cancers and receiving concurrent chemo‐radiotherapy. Design Five hundred and sixty‐nine cancer patients with advanced cancers and treated by chemo‐radiotherapy were analysed in the study. The incidences of peripherally inserted central catheter‐related complications were investigated. Methods Univariable and multivariable logistic regression analyses were employed for identification of risk factors. Results Eighty‐six (15.1%) patients exhibited peripherally inserted central catheter‐related infectious complications, of which 6.3% were local infection, 3.9% were catheter‐related bloodstream infection and 4.9% were exit‐site infection. Sixty‐five (11.4%) developed symptomatic peripherally inserted central catheter‐related thrombosis, and 52 (9.1%) were suffering from phlebitis. The overall complication rate was 53.1%. The univariable logistic regression and multivariate analysis showed that comorbidity (OR 1.51, p = .0148) and body mass index (OR 1.46, p = .0157), and duration of radio‐chemotherapy (OR 1.4733, p = .0049) were significantly associated with peripherally inserted central catheter‐related complications. Patients with peripherally inserted central catheter‐related complications showed lower 5‐year survival rate than those without peripherally inserted central catheter‐related complications. Conclusions Identification of risk factors for peripherally inserted central catheter‐related complications in patients with advanced cancer before catheter usage may play an important role in improvement of the prognosis. Relevance to clinical practice Doctors need to be aware of the risk of peripherally inserted central catheter‐related complications in patients with advanced cancers.

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