Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study
Exterkate, Lotte; van Tienhoven, Arne J; Haaksma, Mark E; Heldeweg, Micah L A; Fleuren, Lucas; Thoral, Patrick; Dam, Tariq A; Heunks, Leo M A; Gommers, Diederik; Cremer, Olaf L; Bosman, Rob J; Rigter, Sander; Wils, Evert-Jan; Frenzel, Tim; Vlaar, Alexander P; Dongelmans, Dave A; de Jong, Remko; Peters, Marco; Kamps, Marlijn J A; Ramnarain, Dharmanand; Nowitzky, Ralph; Nooteboom, Fleur G C A; de Ruijter, Wouter; Urlings-Strop, Louise C; Smit, Ellen G M; Mehagnoul-Schipper, D Jannet; Dormans, Tom; de Jager, Cornelis P C; Hendriks, Stefaan H A; Achterberg, Sefanja; Oostdijk, Evelien; Reidinga, Auke C; Festen-Spanjer, Barbara; Brunnekreef, Gert B; Cornet, Alexander D; van den Tempel, Walter; Boelens, Age D; Koetsier, Peter; Lens, Judith; Faber, Harald J; Karakus, A; Entjes, Robert; de Jong, Paul; Rettig, Thijs C D; Arbous, Sesmu; Vonk, Bas; Machado, Tomas; Girbes, Armand R J; Sieswerda, Elske; Elbers, Paul W G; Tuinman, Pieter R
(2022) Shock (Augusta, Ga.), volume 58, issue 5, pp. 358 - 365
(Article)
Abstract
Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors, and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients. Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible
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CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic health record database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model. Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9% and 9.4 infections per 1,000 catheter indwelling days, respectively. Prone ventilation for more than 5 days was associated with increased risk of suspected catheter-related infection; odds ratio, 5.05 (95% confidence interval 2.12-11.0). Risk of death was significantly higher in patients with suspected catheter-related infection (hazard ratio, 1.78; 95% confidence interval, 1.25-2.53). Conclusions: This study shows that in critically ill patients with COVID-19, prevalence and incidence of suspected catheter-related infection are high, prone ventilation is a risk factor, and mortality is higher in case of catheter-related infection.
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Keywords: catheter-related infections, Central venous catheters, COVID-19, intensive care, Critical Care and Intensive Care Medicine, Emergency Medicine, Journal Article
ISSN: 1073-2322
Publisher: Lippincott Williams & Wilkins
Note: Funding Information: This work was supported by institutional funding only. Publisher Copyright: © Wolters Kluwer Health, Inc. All rights reserved.
(Peer reviewed)