This article is more than 5 years old. Information may no longer be current.
Long-term central venous catheter use increased infection risk in older patients with cancer
Click Here to Manage Email Alerts
Older adult patients with cancer who experienced long-term exposure to central venous catheters demonstrated an increased risk for infection, according to results of a retrospective study.
The association persisted regardless of other risk factors.
“Reducing infections associated with long-term central venous catheters by avoiding unnecessary use or by making their use safer could have a meaningful impact on important patient outcomes,” Allison Lipitz-Snyderman, PhD, of the Center for Health Policy and Outcomes in the department of epidemiology and biostatistics at Memorial Sloan Kettering Cancer Center, and colleagues wrote.
Central venous catheters (CVCs) often are used long term in patients with cancer to allow for the administration of IV fluids and chemotherapy. CVC use can lead to bloodstream infections, but the risks have not been established.
Lipitz-Snyderman and colleagues assessed the impact of long-term CVC use and subsequent risk for infection, independent of chemotherapy and other risk factors.
The analysis included 168,740 Medicare beneficiaries aged 66 years or older diagnosed with cancer between 2005 and 2007. Diagnoses included invasive colorectal, head and neck, pancreatic or lung cancers; invasive or non-invasive breast cancer; and non-Hodgkin’s lymphoma.
About 21% of patients (n=35,299) required CVCs. The percentage of patients who required long-term CVC at 2 years after diagnosis ranged from 13% to 30%, depending on cancer site.
After adjustments for disease and demographic characteristics, patients who required CVCs within 2 years of diagnosis demonstrated a higher risk for infection. Researchers observed the greatest increased infection risk among patients with breast cancer (adjusted HR [aHR]=6.19; 95% CI, 5.42-7.07), followed by non-Hodgkin’s lymphoma (aHR=4.75; 95% CI, 4.32-5.23), head and neck cancers (aHR=4.47; 95% CI, 3.76-5.31); colorectal cancer (aHR=3.49; 95% CI, 3.18-3.81), lung cancer (aHR=3.23; 95% CI, 3.03-3.45) and pancreatic cancer (aHR=2.93; 95% CI, 2.58-3.33).
Researchers observed similar findings when they limited the cohort to individuals at high risk for infections and accounted for propensity to receive a CVC.
“There are two primary means by which infections might be prevented,” Lipitz-Snyderman and colleagues wrote. “One approach is to reduce unnecessary long-term central venous catheter use. When discretionary, comprehensive information on potential harms can inform decision-making regarding treatment administration methods. The second is to implement interventions for infection prevention specific to this patient population that can minimize the potential for harm when long-term central venous catheter use is medically necessary.”
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts