Catheter Failure and Mortality in Hemodialysis Patients with Tunneled Cuffed Venous Catheters in a Single Center

Abstract

Background: As of now, only a few studies have focused on the failure of tunneled cuffed venous catheter (tCVC) and mortality of hemodialysis (HD) patients using tCVC as long-term vascular access, whose vascular condition for arteriovenous fistula was not very satisfactory. In this study, we aimed to provide information about the first tCVC failure and survival rates of patients in this population. Methods: Fifty-nine patients who used tCVC from January 1, 2009 to December 31, 2014 in our HD center were analyzed in this retrospective study and followed up either until their death or until December 31, 2015. The first tCVC and patient survival rates were analyzed. Results: The incidence of catheter-related infections was 0.3 per 1,000 patient-days. The median survival duration of first tCVC was 45.0 (95% CI 29.3-69.7) months and the median survival time of all patients was 56.3 (95% CI 34.1-78.5) months by Kaplan-Meier analysis. Advanced age (hazard ratio [HR] 1.055, p < 0.05) and diabetic mellitus (HR 4.147, p < 0.05) at the initiation of HD were significant risk factors of first tCVC failure, while male (HR 2.712, p < 0.05) and cardiovascular diseases (CVDs; HR 4.139, p < 0.05) were significant risk factors for patient mortality as deduced by Cox proportional hazards methods. Conclusions: The study highlighted that first tCVC survival rates and patient survival rates were high in HD patients who were using tCVCs as long-term vascular access, with low incidence of catheter-related infections. In the study it was found that advanced age and diabetic mellitus at the initiation of HD influenced first tCVC failure, whereas male and CVDs seemed to be risk factors for patient mortality.

Changes to indications for tunneled cuffed catheter use in hemodialysis patients: A single‐center experience

“…However, some studies have described median catheter patency >300 days . Moreover, Shi et al reported extremely good catheter survival (median catheter survival for TCC, 45.0 months) . However, that study had only a few subjects, excluded bridge VA, and the age of subjects was younger than in our study.…”

“…Low catheter survival in our study was because all catheter removal (including planned catheter removal) or death of the catheter was analyzed as an event. The incidence of catheter‐related infection has been reported as 0.3–1.0 per 1000 patient days . We observed a relatively low incidence of catheter‐related infection and the incidence did not differ between the early phase and late‐phase groups.…”

“…The incidence of catheter-related infection has been reported as 0.3-1.0 per 1000 patient days. 21,22 We observed a relatively low incidence of catheter-related infection and the incidence did not differ between the early phase and late-phase groups. Of the 95 TCC-inserted patients, 53 (55.8%) died within the whole study period.…”

“…19,20 Moreover, Shi et al reported extremely good catheter survival (median catheter survival for TCC, 45.0 months). 21 However, that study had only a few subjects, excluded bridge VA, and the age of subjects was younger than in our study. Low catheter survival in our study was because all catheter removal (including planned catheter removal) or death of the catheter was analyzed as an event.…”

Análise das taxas de infecção e duração de cateteres de hemodiálise de curta e longa permanência em hospital de ensino

“…As taxas de sobrevida de cateter observadas neste estudo estão abaixo da maioria dos trabalhos encontrados na literatura, apesar de não haver estudo que compare especificamente os CCP e CTLP. Mandolfo et al 16 encontraram uma sobrevida cumulativa de CTLP de 91% em 1 ano e de 85% em 4 anos, enquanto Shi et al 17 observaram sobrevida de 82% em 1 ano e de 42% em 4 anos. Por outro lado, Shingarev et al 14 descreveram taxas de perviedade de cateteres bem Tabela 3.…”