医学
急诊医学
门诊部
回顾性队列研究
中心静脉导管
队列
导管
外周穿刺中心静脉导管
急诊科
门诊护理
观察研究
队列研究
人口
重症监护医学
内科学
医疗保健
外科
护理部
经济
环境卫生
经济增长
作者
Steven S Spires,Peter F. Rebeiro,Mickie Miller,Katie Koss,Patty W. Wright,Thomas R. Talbot
摘要
OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line–associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services. Risk factors for medically attended catheter-associated complications (CACs) and outpatient CLABSIs were analyzed. RESULTS A CAC developed in 143 patients (21.9%), for a total of 165 discrete CAC events. Among these, 76 (46%) required at least 1 visit to the emergency department or an inpatient admission, while the remaining 89 (54%) required an outpatient clinic visit. The risk for developing a CAC was significantly increased in female patients, patients with a CVC with >1 lumen, and patients receiving total parenteral nutrition. The absolute number of CLABSIs identified in the study population was small at 16, or 2.4% of the total cohort. CONCLUSIONS Medically attended catheter complications were common among outpatients discharged with a CVC, and reduction of these events should be the focus of outpatient quality improvement programs. Infect Control Hosp Epidemiol 2018;39:439–444
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