Risk Factors for Catheter-Related Bloodstream Infection in Patients Undergoing Hemodialysis: A Systematic Review And Meta-Analysis

Abstract

Background: Catheter-Related Bloodstream Infection (CRBSI) is a common and life-threatening complication of hemodialysis, with high morbidity and mortality. This meta-analysis was performed to analyze the risk factors of CRBSI in patients undergoing hemodialysis. Methods: The search process included the electronic databases of CNKI, WANGFANG, PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to July 2021. The quality assessment of the included studies was conducted according to the Newcastle-Ottawa Scale (NOS). The Odds ratios (ORs) with corresponding 95% confidence intervals (95%CIs) were calculated to assess the strength of the association of risk factors with CRBSI using RevMan 5.4 software in the current study. Results: A total of 23 pieces of literature were included in this study, counting a total of 10335 patients, including 1165 patients with CRBSI and 9170 patients without CRBSI. Meta analysis results showed that puncture times [OR=3.22, 95% CI (2.42, 4.27)], femoral vein catheterization (OR=1.69, 95%CI 1.38-2.08, P＜0.00001), catheter indwelling time (OR = 2.22, 95% CI 1.62-3.04, P < 0.0001), age (OR =1.69, 95%CI 1.49-1.91, P < 0.0001), diabetes mellitus (OR=1.92, 95%CI 1.71-2.15, P< 0.00001), dialysis time (OR = 2.89, 95%CI 1.82-4.59, P <0.0001), duration of hospitalization (OR =2.49, 95%CI 1.47-4.23,P =0.0006) and hypoproteinemia (OR =3.19, 95%CI 2.08-4.89, P＜0.0001) were risk factors for CRBSI.Conclusions: Catheter retention time, age, femoral vein catheterization, diabetes, hospitalization time and hypoproteinemia were risk factors for CRBSI in hemodialysis patients.