Details

Autor(en) / Beteiligte

• van Oevelen, Mathijs
• Abrahams, Alferso C
• Weijmer, Marcel C
• Nagtegaal, Tjerko
• Dekker, Friedo W
• Rotmans, Joris I
• Meijvis, Sabine CA
• Bijlsma, J.A.
• van der Bogt, K.E.A.
• van de Brug, A.
• Douma, C.E.
• Hoorn, E.J.
• IJpelaar, D.H.T.
• Krol-van Straaten, M.J.
• Mui, K.W.
• Tordoir, J.H.M.
• Vincent, H.H.
• Zonnebeld, N.

Titel

Precurved non-tunnelled catheters for haemodialysis are comparable in terms of infections and malfunction as compared to tunnelled catheters: A retrospective cohort study

Ist Teil von

• The journal of vascular access, 2019-05, Vol.20 (3), p.307-312

Ort / Verlag

London, England: SAGE Publications

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: The main limitations of central venous catheters for haemodialysis access are infections and catheter malfunction. Our objective was to assess whether precurved non-tunnelled central venous catheters are comparable to tunnelled central venous catheters in terms of infection and catheter malfunction and to assess whether precurved non-tunnelled catheters are superior to straight catheters. Materials and methods: In this retrospective, observational cohort study, adult patients in whom a central venous catheter for haemodialysis was inserted between 2012 and 2016 were included. The primary endpoint was a combined endpoint consisting of the first occurrence of either an infection or catheter malfunction. The secondary endpoint was a combined endpoint of the removal of the central venous catheter due to either an infection or a catheter malfunction. Using multivariable analysis, cause-specific hazard ratios for endpoints were calculated for tunnelled catheter versus precurved non-tunnelled catheter, tunnelled catheter versus non-tunnelled catheter, and precurved versus straight non-tunnelled catheter. Results: A total of 1603 patients were included. No difference in reaching the primary endpoint was seen between tunnelled catheters, compared to precurved non-tunnelled catheters (hazard ratio, 0.91; 95% confidence interval, 0.70–1.19, p = 0.48). Tunnelled catheters were removed less often, compared to precurved non-tunnelled catheters (hazard ratio, 0.65; 95% confidence interval, 0.46–0.93; p = 0.02). A trend for less infections and catheter malfunctions was seen in precurved jugular non-tunnelled catheters compared to straight non-tunnelled catheters (hazard ratio, 0.60; 95% confidence interval, 0.24–1.50; p = 0.28) and were removed less often (hazard ratio, 0.41; 95% confidence interval, 0.18–0.93; p = 0.03). Conclusion: Tunnelled central venous catheters and precurved non-tunnelled central venous catheters showed no difference in reaching the combined endpoint of catheter-related infections and catheter malfunction. Tunnelled catheters get removed less often because of infection/malfunction than precurved non-tunnelled catheters.