癌症患者早期导管相关感染的风险因素

David

Cancer. 2007 Aug 8;110(7):1586-1592 [Epub ahead of print] Links

Risk factors for early catheter-related infections in cancer patients.Penel N, Neu JC, Clisant S, Hoppe H, Devos P, Yazdanpanah Y.
Department of General Oncology, Oscar Lambret Cancer Center, Lille, France.

BACKGROUND.: Early catheter-related infection is a serious complication in cancer treatment, although risk factors for its occurrence are not well established. The authors conducted a prospective study to identify the risk factors for developing early catheter-related infection. METHODS.: All consecutive patients with cancer who underwent insertion of a central venous catheter were enrolled and were followed prospectively during 1 month. The study endpoint was occurrence of early catheter-related infection. RESULTS.: Over 10,392 catheter-days of follow-up, 14 of 371 patients had early catheter-related infections (14 patients in 10,392 catheter-days or 1.34 per 1000 catheter-days). The causative pathogens were gram positive in 11 of 14 patients. In univariate analysis, the risk factors for early catheter-related infection were aged <10 years (P = .0001), difficulties during insertion (P < 10(-6)), blood product administration (P < 10(-3)), parenteral nutrition (P < 10(-4)), and use >2 days (P < 10(-6)). In multivariate analysis, 3 variables remained significantly associated with the risk of early catheter-related infection: age <10 years (odds ratio [OR], 18.4; 95% confidence interval [95% CI], 1.9-106.7), difficulties during insertion procedure (OR, 25.6; 95% CI, 4.2-106), and parenteral nutrition (OR, 28.5; 95% CI, 4.2-200). CONCLUSIONS.: On the day of insertion, 2 variables were identified that were associated with a high risk of developing an early catheter-related infection: young age and difficulties during insertion. The results from this study may be used to identify patients who are at high risk of infection who may be candidates for preventive strategies. Cancer 2007. (c) 2007 American Cancer Society.

右手心

景:早期导管相关感染是癌症病人治疗中的一种严重并发症.虽然它的发生机制没有确切建立.作者做了一个前瞻性的调查去确定发生早期导管相关感染的危险因素.
方法:所有插有中心静脉导管的长期癌症病人为研究对象,追踪调查1一个.这个研究的调查终点是发生早期导管相关感染.
结果:追踪插管天数超过了10392天,371个病人中发生早期导管相关病人有14人。(10392天插管日里发生14个病人插管感染,或者每1000天插管日会发生1.34个病人插管感染).14个感染病人中,有11个病人病原菌阳性.单变量分析,发生早期导管相关感染的危险因素为年龄小于10岁(P=0.001),插管困难,血制品使用,大于2日的胃肠外营养.多变量分析,仍然有3个变量与发生早期导管相关感染有关:年龄小于10岁(比值比,18.4,95%可信区间,1.9-106.7),插管困难(比值比,25.6;95%可信区间4.2-106),和胃肠道外营养(比值比28.5,95%可信区间,4.2-200)
结论:插管的时候,年龄偏小和插管困难被确定为容易感染导管相关感染的高危险因素.这个研究的结论可能用于鉴定哪些病人是高危险感染人群,以便开展预防策略.