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Medically Attended Catheter Complications Are Common in Patients With Outpatient Central Venous Catheters

Published online by Cambridge University Press:  15 February 2018

Steven S. Spires ,
Peter F. Rebeiro ,
Mickie Miller ,
Katie Koss ,
Patty W. Wright  and
Thomas R. Talbot
Steven S. Spires*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Peter F. Rebeiro
Affiliation:
Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Mickie Miller
Affiliation:
Vanderbilt Home Care Services, Nashville, Tennessee
Katie Koss
Affiliation:
Vanderbilt Home Care Services, Nashville, Tennessee
Patty W. Wright
Affiliation:
Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Thomas R. Talbot
Affiliation:
Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee
*
Address correspondence to Steven S. Spires, MD, Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, A2200 MCN, 1161 21st Ave South, Nashville, TN 37232-2605 (steven.s.spires@vanderbilt.edu).
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Abstract

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

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 4 , April 2018 , pp. 439 - 444
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. A portion of the findings of this study was presented as an oral abstract presentation at the Society for Healthcare Epidemiology of America Spring Conference on May 15, 2015, in Orlando, Florida.

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