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Infect Control Hosp Epidemiol ; 39(4): 439-444, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29444733

RESUMO

OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services. Risk factors for medically attended catheter-associated complications (CACs) and outpatient CLABSIs were analyzed. RESULTS A CAC developed in 143 patients (21.9%), for a total of 165 discrete CAC events. Among these, 76 (46%) required at least 1 visit to the emergency department or an inpatient admission, while the remaining 89 (54%) required an outpatient clinic visit. The risk for developing a CAC was significantly increased in female patients, patients with a CVC with >1 lumen, and patients receiving total parenteral nutrition. The absolute number of CLABSIs identified in the study population was small at 16, or 2.4% of the total cohort. CONCLUSIONS Medically attended catheter complications were common among outpatients discharged with a CVC, and reduction of these events should be the focus of outpatient quality improvement programs. Infect Control Hosp Epidemiol 2018;39:439-444.


Assuntos
Infecções Relacionadas a Cateter , Cateteres Venosos Centrais/efeitos adversos , Serviços de Assistência Domiciliar , Uso Excessivo dos Serviços de Saúde , Readmissão do Paciente/estatística & dados numéricos , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/terapia , Feminino , Serviços de Assistência Domiciliar/normas , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Masculino , Uso Excessivo dos Serviços de Saúde/prevenção & controle , Uso Excessivo dos Serviços de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Nutrição Parenteral no Domicílio/métodos , Nutrição Parenteral no Domicílio/estatística & dados numéricos , Melhoria de Qualidade , Fatores de Risco , Fatores Sexuais , Tennessee/epidemiologia
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