Document Detail


A prospective observational study of catheter-related bacteraemia and thrombosis in a haemodialysis cohort: univariate and multivariate analyses of risk association.
MedLine Citation:
PMID:  20054025     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Central venous catheterization is a fundamental component in delivering haemodialysis yet is associated with significantly higher complication rates than other methods of vascular access. In this study, we report results of univariate and multivariate analyses designed to identify and quantify independent risk association for catheterization type, clinical variables and laboratory variables with regard to the development of catheter-related bacteraemia (CRB) and catheter failure due to poor haemodialysis flow. METHODS: A 2-year prospective study of all incident haemodialysis vascular access catheter insertions was conducted. Laboratory and clinical variables were recorded at catheter insertion, and the clinical course was followed up to the point of catheter removal. CRB and catheter failure due to poor flow were recorded as outcome events. Univariate and multivariate analyses were used to test for association between clinical and laboratory variables and outcome. RESULTS: Forty-four thousand five hundred seventy-six catheter days were accumulated over the study period. Multivariate analysis demonstrated an independent association between non-tunnelled catheterization procedures and adverse outcomes compared with tunnelled central venous catheter insertions. Elevated modified Charlson comorbidity score was independently associated with the development of CRBc. Elevated C-reactive protein and low haemodialysis blood pump flow were independently associated with catheter failure due to poor flow. CONCLUSIONS: The data demonstrate that tunnelled central venous catheter insertions have an association with lower complication rates than non-tunnelled central venous catheter insertions that is independent of whether patients have acute or chronic renal failure, or high levels of comorbidity.
Authors:
Peter Thomson; Catherine Stirling; Jamie Traynor; Scott Morris; Robert Mactier
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Publication Detail:
Type:  Journal Article     Date:  2010-01-06
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1596-604     Citation Subset:  IM    
Affiliation:
Glasgow Royal Infirmary, Renal Unit. pcthomson@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bacteremia / etiology*
C-Reactive Protein / analysis
Catheter-Related Infections / etiology*
Cohort Studies
Female
Humans
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Renal Dialysis / adverse effects*
Risk
Thrombosis / etiology*
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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