Candidemia in cancer patients: Impact of early removal of non-tunneled central venous catheters on outcome - 07/08/11
Correspondence to: T.J. Chiou, Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan, ROC. Tel.: +886 2 28757859; fax: +886 2 28757874.Summary |
Objective |
To explore the impact of retention of non-tunneled central venous catheters (CVCs) on survival in candidemic cancer patients, where CVCs are commonly used and essential. A second object was to determine whether early CVC removal would benefit a subset of cancer patients.
Methods |
We retrospectively evaluated 92 cancer patients who had a single, non-tunneled CVC in place. Patients were grouped according to CVC retention or removal; the later group was subdivided into early (CVC removed ≤72h after candidemia onset) and late removal. A Cox regression model was used for determining risk factors of adverse outcome and Kaplan–Meier analyses for comparing in-hospital 3–30 day survival among subgroups.
Results |
Baseline characteristics were comparable between CVC retention (n=20) or removal (n=72) groups. CVC retention was a significant risk factor of poor outcome, independent of other significant prognostic host factors (hazard ratio 7.15, 95% confidence interval 3.51–14.53, p<0.001). Patients of early CVC removal (n=40) had significant better survival than those of late removal (n=32) (p<0.001).
Conclusion |
The results suggest that retention of CVCs has a negative impact on survival in candidemic cancer patients, and that early CVC removal should be considered in a subset of cancer patients with candidemia.
Le texte complet de cet article est disponible en PDF.Keywords : Central venous catheter, Candidemia, Cancer
Plan
Vol 58 - N° 2
P. 154-160 - février 2009 Retour au numéro
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