Incidence, risk factors and clinical outcomes of peripherally inserted central catheter spontaneous dislodgment in oncology patients: A prospective cohort study.
Purpose: Peripherally inserted central catheter (PICC) spontaneous dislodgment is insidious in onset and prone to cause complications. We performed a prospective cohort study to examine the incidence, risk factors and clinical results of PICC spontaneous dislodgment in oncology patients to facilitat...
| Publicado en: | International Journal of Nursing Studies Vol. 51; no. 7; pp. 955 - 964 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103959631&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103959631 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00207489 JHV jtl: International Journal of Nursing Studies issn: 00207489 maglogo: N pubinfo: dt: 2014 vid: 51 iid: 7 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 103959631 96521313 10.1016/j.ijnurstu.2013.10.021 NLM24246096 103959631 ppf: 955 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Incidence, risk factors and clinical outcomes of peripherally inserted central catheter spontaneous dislodgment in oncology patients: A prospective cohort study. aug: au: Xiao-xia Qiu Yan Guo Hong-bin Fan Jie Shao Xue-bin Zhang affil: Cancer Center, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200127, China sug: subj: Peripherally Inserted Central Catheters Adverse Effects Foreign-Body Migration Epidemiology Foreign-Body Migration Risk Factors Catheterization, Peripheral Central Venous Adverse Effects Catheter-Related Complications Epidemiology Catheter-Related Complications Risk Factors Catheter Care, Peripherally Inserted Central Outcomes (Health Care) Human Funding Source Prospective Studies Foreign-Body Migration Radiography Foreign-Body Migration Complications Catheter-Related Thrombosis Epidemiology Catheter-Related Thrombosis Risk Factors Relative Risk Confidence Intervals Insertion Sites Catheter Placement Determination Treatment Duration Interviews After Care Record Review China Catheter Removal Chi Square Test Fisher's Exact Test Mann-Whitney U Test Univariate Statistics Multiple Logistic Regression P-Value Kaplan-Meier Estimator Data Analysis Software Academic Medical Centers Male Female Adolescence Adult Middle Age Aged Aged, 80 and Over Inpatients Descriptive Statistics Hemodynamics Equipment Failure Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: Peripherally inserted central catheter (PICC) spontaneous dislodgment is insidious in onset and prone to cause complications. We performed a prospective cohort study to examine the incidence, risk factors and clinical results of PICC spontaneous dislodgment in oncology patients to facilitate successful early diagnosis, prophylaxis and management. Patients and methods: Consecutive oncology patients, undergoing placement of PICCs, were enrolled and prospectively followed up until their catheters were removed or PICC spontaneous dislodgment presented. The patients with PICC spontaneous dislodgment or catheter-associated thrombosis (CRT) were followed up for an extra three months from the date of diagnosis. The main endpoint was PICC spontaneous dislodgment, and the subendpoints were CRT and catheter in-place time. The PICC insertion team, nurses, interventional radiologists and oncology doctors collected longitudinal data. Results: Over a total of 60,894 days of cumulative follow-up, 21 out of 510 PICCs presented spontaneous dislodgment, leading to an incidence rate of 4.12%. The CRT rate of the group with PICC spontaneous dislodgment was much higher than that of the group without PICC spontaneous dislodgment (RR = 17.46, 95% CI: 8.29-36.82, p = 1.09 × 10-17). Five baseline exposure factors, including primary lung cancer, metastatic lung cancer, chest radiotherapy, vigorous coughing and severe vomiting, were significant risk factors of PICC spontaneous dislodgment. Basilic vein access (odds ratio [OR] = 0.39, 95% CI: 0.16- 0.95, P = 0.04) was a protective factor against PICCSD in univariate analysis. Among these factors, the independent significant risk factors were vigorous coughing (OR = 6.14, 95% CI: 1.70-22.16, P = 0.01) and severe vomiting (OR = 3.70, 95% CI: 1.28-10.68, P = 0.02). Conclusion: The incidence rate of PICC spontaneous dislodgment is 4.12% (0.34 per 1000 catheter-days); PICC spontaneous dislodgment significantly increases the risk of CRT and shortens catheter in-place time. Vigorous coughing and severe vomiting were indepen- dent risk factors of PICC spontaneous dislodgment among oncology patients. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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