Validation of a new method developed to measure the height of adult patients in bed.

UNLABELLED: We present the performance of a new instrument developed to measure the height of patients in bed (Luft Ruler). METHODS: Standing height was the gold standard measured in 116 hospitalized adults with a stadiometer, compared with measurements from the Luft Ruler and calculated estimates. RESULTS: Using the Luft Ruler in women, men, <60 years old, and >60 years old, the mean difference from the gold standard was, respectively, 1.5 cm (P= .02), 1.3 cm (P= .06), 1.2 cm (P= .07), and 1.6 cm (P= .02); total arm span: 6.7 cm, 7.7 cm, 5.4 cm, and 9.0 cm (P< .01 for all strata); 2x half arm span: 7.8 cm, 10.2 cm, 7.7 cm, and 10.3 cm (P< .01 for all); World Health Organization (WHO) equation: 5.5 cm, 6.2 cm, 4.7 cm, and 6.9 cm (P< .01 for all); and the Hospital de Clínicas de Porto Alegre equation: 1.9 cm (P< .01), 2.5 cm (P< .01), 1.1 cm (P= .12), and 3.3 cm (P< .01). The proportion of differences >5 cm was 0.9% (n=1) using the Luft Ruler, 62.9% using total arm span, 71.6% using 2x half arm span, 64.7% using the WHO equation, and 27.6% using the Hospital de Clínicas de Porto Alegre equation. CONCLUSIONS: The Luft Ruler was the only method that presented minor mean differences in relation to the gold standard in both gender and age strata. The other estimates are not recommended because of high frequency of relevant errors.

Parenteral nutrition as a risk factor for central venous catheter-related infection.

BACKGROUND: The role of parenteral nutrition (PN) therapy as an independent risk factor for central venous catheter (CVC)-related infection in nonselected adult patients is not well established. The aim of this study was to evaluate PN as a risk factor for central venous catheter-related infection in nonselected adult patients in a general university hospital. METHODS: Patients using central venous catheters, exposed or nonexposed to PN, were prospectively followed for development of central venous catheter-related infection. RESULTS: One hundred fifty-three patients were studied; 28 developed central venous catheter-related infection. Patients with central venous catheter-related infection presented higher frequency of PN use than patients without infection (60.7 vs 34.4%; p = .010). Multivariate Cox analysis showed that PN (relative risk (RR) = 3.30; 95% confidence interval [CI], 1.30-8.34; p = .012) was the only risk factor for central venous catheter-related infection. Malnutrition (RR = 0.45; 95% CI, 0.15-1.34; p = .152), days of hospitalization before central venous catheter insertion (RR = 1.00; 95% CI, 0.98-1.02; p = .801), and sustained hyperglycemia (RR = 0.49; 95% CI, 0.98-1.21; p = .091) were not significant in the model. Multiple logistic regression revealed that mal-nutrition (odds ratio [OR] = 8.05; 95% CI, 1.85-35.03; p = .005), central venous catheter indication for surgical-related pathology (OR = 7.26; 95% CI, 2.51-21.04; p < .001), sustained hyperglycemia (OR = 4.34; 95% CI, 1.79-10.52; p = .001), and days of hospitalization before central venous catheter insertion (OR = 1.04; 95% CI, 1.01-1.07; p = .004) were associated with PN use after adjustment for Assessment Score Intervention System score (OR = 0.33; 95% CI, 0.14-0.80; p = .014). CONCLUSIONS: PN therapy is an independent risk factor for central venous catheter-related infection in nonselected hospitalized adult patients.