Association of immediate reinsertion of new catheters with subsequent mortality among patients with suspected catheter infection: a cohort study

Zhong, Yaohong; Deng, Liehua; Zhou, Limin; Liao, Shaoling; Yue, Liqun; Wen, Shi Wu; Xie, Ri-Hua; Lu, Yuezhen; Zhang, Liangqing; Tang, Jing; Zhou, Haihong

doi:10.1186/s13613-022-01014-8

Cited by 9 publications

(10 citation statements)

References 44 publications

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“…First, electronic medical records from the MIMIC-IV database were used, which have a high focus on patients admitted to ICUs with a large sample size, thereby providing strong evidence for our conclusions. Second, we obtained the same result after adjusting the baseline level by using PSM and IPW and establishing a series Cox regression models to adjust various confounding factors, which further confirmed the reliability of the results (Zhong et al, 2022). However, this study also has some limitations.…”

Section: Discussionsupporting

confidence: 75%

Association of thiamine administration and prognosis in critically ill patients with heart failure

et al. 2023

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Background: Thiamine deficiency is common in patients with heart failure, and thiamine supplement can benefit these patients. However, the association between thiamine administration and prognosis among critically ill patients with heart failure remains unclear. Thus, this study aims to prove the survival benefit of thiamine use in critically ill patients with heart failure.Methods: A retrospective cohort analysis was performed on the basis of the Medical Information Mart of Intensive Care-Ⅳ database. Critically ill patients with heart failure were divided into the thiamine and non-thiamine groups depending on whether they had received thiamine therapy or not during hospitalization. The association between thiamine supplement and in-hospital mortality was assessed by using the Kaplan−Meier (KM) method and Cox proportional hazard models. A 1:1 nearest propensity-score matching (PSM) and propensity score-based inverse probability of treatment weighting (IPW) were also performed to ensure the robustness of the findings.Results: A total of 7,021 patients were included in this study, with 685 and 6,336 in the thiamine and non-thiamine groups, respectively. The kaplan−meier survival curves indicated that the thiamine group had a lower in-hospital mortality than the none-thiamine group. After adjusting for various confounders, the Cox regression models showed significant beneficial effects of thiamine administration on in-hospital mortality among critically ill patients with heart failure with a hazard ratio of 0.78 (95% confidence interval: 0.67–0.89) in the fully adjusted model. propensity-score matching and probability of treatment weighting analyses also achieved consistent results.Conclusion: Thiamine supplement is associated with a decreased risk of in-hospital mortality in critically ill patients with heart failure who are admitted to the ICU. Further multicenter and well-designed randomized controlled trials with large sample sizes are necessary to validate this finding.

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Section: Discussionsupporting

confidence: 75%

Association of thiamine administration and prognosis in critically ill patients with heart failure

et al. 2023

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“…Propensity score matching was used to balance the differences in baseline characteristics between patients in the non-FNT period and those in the FNT period. A propensity score, the probability of the FNT period, was estimated using logistic regression based on sex, age, diabetes, hypertension, surgical wound classification, and surgery type [ 33 ]. Propensity score matching was implemented using a nearest-neighbour strategy with a minimum calliper of 0.1 [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of a fixed nurse team in the orthopaedic surgery operating room on work efficiency and patient outcomes: a propensity score-matched historically controlled study

et al. 2022

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Background The work value of operating room (OR) nurses is directly reflected in nursing quality. However, evaluating the work value of these nurses has not been sufficiently investigated. This study evaluated the effects of a fixed nurse team (FNT) in an orthopaedic surgery OR on work efficiency and patient outcomes. Methods A propensity score-matched historically controlled study conducted from 1 July 2015 to 30 June 2018 was used to investigate the difference in nursing quality between an FNT period and a non-FNT period in the orthopaedic surgery OR at a tertiary care hospital in China. The primary outcome was surgical site infections (SSIs) during in-hospital visits, and as a secondary outcome, other nursing-sensitive quality indicators were assessed with historically controlled data. A multifactor logistic regression model was constructed to examine the primary outcome differences between the FNT and non-FNT periods before and after propensity score matching. Results In total, 5365 patients and 33 nurses were included in the final analysis. The overall SSI rate was 2.1% (110/5365; the non-FNT period 2.6% [64/2474], the FNT period 1.6% [46/2891]). A lower incidence of SSIs in patients (odds ratio 0.57, 95% CI 0.36 to 0.88, P=0.013), a lower turnover time of the surgical procedure (odds ratio 0.653, 95% CI 0.505 to 0.844, P<0.001), and improvement in surgeon satisfaction (odds ratio 1.543, 95% CI 1.039 to 2.292, P=0.031), were associated with the FNT period compared with the non-FNT period. However, we did not find significant differences between the FNT period and the non-FNT period in terms of the other indicators. Conclusions The presence of an FNT in an OR reduces the incidence of SSIs in surgical patients and the turnover time of surgical procedures and improves surgeon satisfaction. Further implementation of an advanced-practice nurse model with nurse specialists is encouraged.

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“…Of note, the fear of CRBSI on its own may trigger CVC replacement in a new anatomical site. However, systematic CVC replacement also exposes patients to potential harm [ 17 ]. These include mechanical complications when inserting a CVC in a new site.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a multivariable prediction model of central venous catheter-tip colonization in a cohort of five randomized trials

et al. 2022

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Background The majority of central venous catheters (CVC) removed in the ICU are not colonized, including when a catheter-related infection (CRI) is suspected. We developed and validated a predictive score to reduce unnecessary CVC removal. Methods We conducted a retrospective cohort study from five multicenter randomized controlled trials with systematic catheter-tip culture of consecutive CVCs. Colonization was defined as growth of ≥103 colony-forming units per mL. Risk factors for colonization were identified in the training cohort (CATHEDIA and 3SITES trials; 3899 CVCs of which 575 (15%) were colonized) through multivariable analyses. After internal validation in 500 bootstrapped samples, the CVC-OUT score was computed by attaching points to the robust (> 50% of the bootstraps) risk factors. External validation was performed in the testing cohort (CLEAN, DRESSING2 and ELVIS trials; 6848 CVCs, of which 588 (9%) were colonized). Results In the training cohort, obesity (1 point), diabetes (1 point), type of CVC (dialysis catheter, 1 point), anatomical insertion site (jugular, 4 points; femoral 5 points), rank of the catheter (second or subsequent, 1 point) and catheterization duration (≥ 5 days, 2 points) were significantly and independently associated with colonization . Area under the ROC curve (AUC) for the CVC-OUT score was 0.69, 95% confidence interval (CI) [0.67–0.72]. In the testing cohort, AUC for the CVC-OUT score was 0.60, 95% CI [0.58–0.62]. Among 1,469 CVCs removed for suspected CRI in the overall population, 1200 (82%) were not colonized. The negative predictive value (NPV) of a CVC-OUT score < 6 points was 94%, 95% CI [93%–95%]. Conclusion The CVC-OUT score had a moderate ability to discriminate catheter-tip colonization, but the high NPV may contribute to reduce unnecessary CVCs removal. Preference of the subclavian site is the strongest and only modifiable risk factor that reduces the likelihood of catheter-tip colonization and consequently the risk of CRI. Clinical Trials Registration: NCT00277888, NCT01479153, NCT01629550, NCT01189682, NCT00875069.

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Association of immediate reinsertion of new catheters with subsequent mortality among patients with suspected catheter infection: a cohort study

Cited by 9 publications

References 44 publications

Association of thiamine administration and prognosis in critically ill patients with heart failure

Association of thiamine administration and prognosis in critically ill patients with heart failure

Effects of a fixed nurse team in the orthopaedic surgery operating room on work efficiency and patient outcomes: a propensity score-matched historically controlled study

Development and validation of a multivariable prediction model of central venous catheter-tip colonization in a cohort of five randomized trials

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