Presenter Status
Student
Abstract Type
QI
Primary Mentor
J. Allyson Hays, MD
Start Date
15-5-2024 11:30 AM
End Date
15-5-2024 1:30 PM
Presentation Type
Poster Presentation
Description
Background
Central venous catheters (CVCs) are a mainstay of pediatric cancer treatment for but have risks. CVCs can cause local site infections and systemic infections, known as central-line-associated bloodstream infections (CLABSIs). Analyzing rates of complications associated with different CVCs may inform future decisions about CVC choice. Hypotheses We hypothesized that tunneled cuffed (tunneled) catheters will have higher rates of CLABSIs compared to implanted ports (port) and ports will have higher rates of local site infections compared to tunneled.
Methods
Retrospective chart review of patients with acute myeloid leukemia (AML) at Children’s Mercy Hospital (CMH) identified patients treated from 2010 to 2022. Demographic data, CVC placement details and CVC-associated infectious or non-infectious complications collected. CVCs were categorized as tunneled, port, peripherally inserted central catheter (PICC), or other. One-tailed t-tests used to compare rates of CLABSI and local site infection each per 1000-line days for port and tunneled catheters. ANOVA test was used to compare the rate of non-infectious complications per 1000-line days for the three CVC types.
Results
Ninety identified patients included 48 females, 42 males; median age at AML diagnosis 7.54 years and 218 CVCs utilized (100 tunneled, 48 ports, 62 PICCs, 8 other). Infectious CVC-associated infections occurred 154 times (6 local and 148 CLABSIs). Non-infectious complications occurred in 32 CVCs with removal in 31 cases. Tunneled catheters averaged 10.1 CLABSIs and 1.56 local site infections per 1000-line days, and ports averaged 4.18 CLABSIs and 3.08 local site infections per 1000-line days. One-tailed t-tests showed significantly higher rate of CLABSIs per 1000-line days for tunneled compared to ports (t=1 .99, df=139, p=0.049), but not significant difference in rate of local site infections per 1000-line days for tunneled and ports. ANOVA test showed a significant effect of CVC type on rate of non-infectious complications per 1000-line days (F=6.17, df=2, p=0.003). PICCs had significantly higher rate compared to both ports (p=0.026) and tunneled catheters (p = 0.003).
Conclusions:
In this single center retrospective review the choice of tunneled cuffed line increased risk of CLABSI but not local site infections. The choice of PICCs increased the risk of non-infectious complications.
Included in
Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Science and Mathematics Education Commons
Central Venous Catheter-Associated Complications in Pediatric Patients with Acute Myeloid Leukemia
Background
Central venous catheters (CVCs) are a mainstay of pediatric cancer treatment for but have risks. CVCs can cause local site infections and systemic infections, known as central-line-associated bloodstream infections (CLABSIs). Analyzing rates of complications associated with different CVCs may inform future decisions about CVC choice. Hypotheses We hypothesized that tunneled cuffed (tunneled) catheters will have higher rates of CLABSIs compared to implanted ports (port) and ports will have higher rates of local site infections compared to tunneled.
Methods
Retrospective chart review of patients with acute myeloid leukemia (AML) at Children’s Mercy Hospital (CMH) identified patients treated from 2010 to 2022. Demographic data, CVC placement details and CVC-associated infectious or non-infectious complications collected. CVCs were categorized as tunneled, port, peripherally inserted central catheter (PICC), or other. One-tailed t-tests used to compare rates of CLABSI and local site infection each per 1000-line days for port and tunneled catheters. ANOVA test was used to compare the rate of non-infectious complications per 1000-line days for the three CVC types.
Results
Ninety identified patients included 48 females, 42 males; median age at AML diagnosis 7.54 years and 218 CVCs utilized (100 tunneled, 48 ports, 62 PICCs, 8 other). Infectious CVC-associated infections occurred 154 times (6 local and 148 CLABSIs). Non-infectious complications occurred in 32 CVCs with removal in 31 cases. Tunneled catheters averaged 10.1 CLABSIs and 1.56 local site infections per 1000-line days, and ports averaged 4.18 CLABSIs and 3.08 local site infections per 1000-line days. One-tailed t-tests showed significantly higher rate of CLABSIs per 1000-line days for tunneled compared to ports (t=1 .99, df=139, p=0.049), but not significant difference in rate of local site infections per 1000-line days for tunneled and ports. ANOVA test showed a significant effect of CVC type on rate of non-infectious complications per 1000-line days (F=6.17, df=2, p=0.003). PICCs had significantly higher rate compared to both ports (p=0.026) and tunneled catheters (p = 0.003).
Conclusions:
In this single center retrospective review the choice of tunneled cuffed line increased risk of CLABSI but not local site infections. The choice of PICCs increased the risk of non-infectious complications.
