Perioperative neutropenia is not an independent risk factor for infectious complications of central venous line placement in children: A propensity score-matched analysis.
J Pediatr Surg
; 55(7): 1339-1343, 2020 Jul.
Article
en En
| MEDLINE
| ID: mdl-31515110
ABSTRACT
BACKGROUND:
The infectious risk of central venous line (CVL) placement in children with neutropenia (absolute neutrophil count [ANC] <500/mm3) is not well defined. This study aims to investigate the early (≤30â¯days) and late (>30â¯days) infectious complications of CVLs placed in pediatric patients with and without neutropenia.METHODS:
A retrospective review was conducted of all CVLs placed by pediatric surgeons at two institutions from 2010 to 2017. Multivariable logistic regression was performed to identify risk factors for line infection. Propensity score-matched cohorts of patients with and without neutropenia were compared in a 11 ratio. Wilcoxon rank-sum, Chi-square, Fisher's exact, and log-rank tests were also performed.RESULTS:
Review identified 1,102 CVLs placed in 937 patients. Fifty-four patients were neutropenic at the time of placement. Multivariable analysis demonstrated tunneled catheters and subclavian access as associated with line infection. The propensity score-matched cohort included 94 patients, 47 from each group. Demographic and preoperative data were similar between the groups (pâ¯>â¯0.05). Patients with neutropenia were no more likely to develop early (4.3% vs. 2.1%, pâ¯=â¯1.000) or late (19.1% vs. 17.0%, pâ¯=â¯1.000) infectious complications than patients without neutropenia, with similar median time to infection (141 vs. 222â¯days, pâ¯=â¯0.370).CONCLUSION:
A policy of selective CVL placement in neutropenic patients with standardized postoperative line maintenance is safe. Future directions include defining criteria by which neutropenic patients could be prospectively selected for safe CVL placement. LEVEL OF EVIDENCE II - Retrospective cohort study.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Cateterismo Venoso Central
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Infecciones Relacionadas con Catéteres
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Neutropenia
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
J Pediatr Surg
Año:
2020
Tipo del documento:
Article