Insertion site of central venous catheter correlates with catheter-related infectious events in patients undergoing intensive chemotherapy

Abstract

Patients undergoing intensive chemotherapy are usually in need for central venous catheters (CVC). Due to contradictory study results, relation of insertion site and CVC-associated complication rate in these patients is not clear. We therefore retrospectively analyzed CVC-related data of all patients undergoing intensive chemotherapy with high risk of febrile neutropenia according to NCCN criteria, who received a CVC at our bone marrow transplantation unit between May 2016 and December 2019. In total, 210 patients received 281 CVC. CVC were placed via either the subclavian-vein (SCV, n = 58; 20%) or the internal-jugular-vein (IJV, n = 223; 80%). Median duration of CVC-lifetime and neutropenic days per CVC were comparable between the two groups (IJV vs SCV: 23 days vs 21 days (p = 0.16) and 12 days vs 11 days (p = 0.65)). Both, time to CVC removal due to local inflammation and time to central line-associated bloodstream infection was significantly shorter in patients with SCV catheters (p = 0.013 and p = 0.045). CVC placed in the IJV were associated with significantly less catheter-related infectious events compared with CVC placed in the SCV. This difference was consistent across different subgroups including 88 patients undergoing allogeneic stem cell transplantation.

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Fig. 1: Event-free catheter days for all CVC (n = 281).
Fig. 2: Event-free catheter days for CVC in patients undergoing allogeneic stem cell transplantation (n = 97).

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TR, DKM, MA, NM, KC, JB, AB, SA, LT, SS, and MB contributed to collection, review, and/or analysis of the data; TR and VL performed statistical analysis of the data; DKM and TR wrote the manuscript.

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Correspondence to Torben Rixecker.

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Rixecker, T., Lesan, V., Ahlgrimm, M. et al. Insertion site of central venous catheter correlates with catheter-related infectious events in patients undergoing intensive chemotherapy. Bone Marrow Transplant (2020). https://doi.org/10.1038/s41409-020-01003-0

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