Abstract | BACKGROUND AND OBJECTIVES: DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used the multicenter Cathedia study cohort of 736 critically ill adults requiring RRT. Cox marginal structural models were used to compare time to catheter-tip colonization at removal (intent-to-treat, primary endpoint) among patients who started IHD (n = 470) versus CRRT (n = 266). On-treatment analysis was also conducted to take into account changes in prescription of RRT modality. RESULTS: Hazard rate of catheter-tip colonization did not increase within the first 10 days of catheter use. Predictors of catheter-tip colonization were higher lactate levels and hypertension, while systemic antibiotics, antiseptics-impregnated catheters, and mechanical ventilation were associated with decreased risk. The incidence of catheter-tip colonization per 1000 catheter-days was 42.7 in the IHD group and 27.7 in the CRRT group (P < 0.01). This association was no longer significant after correction for channeling bias (weighted HR, 0.96; 95% CI: 0.77 to 1.20, P = 0.73). On-treatment analysis revealed an increased risk of primary endpoint during CRRT exposure as compared with IHD exposure (weighted HR, 0.71; 95% CI: 0.56 to 0.92, P < 0.009). CONCLUSIONS:
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Authors | Jean-Jacques Parienti, Audrey E Dugué, Claire Daurel, Jean-Paul Mira, Bruno Mégarbane, Leonard A Mermel, Cédric Daubin, Damien du Cheyron, Members of the Cathedia Study Group |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 5
Issue 8
Pg. 1489-96
(Aug 2010)
ISSN: 1555-905X [Electronic] United States |
PMID | 20558562
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Aged, 80 and over
- Catheter-Related Infections
(etiology, microbiology, prevention & control)
- Catheterization, Central Venous
(adverse effects, instrumentation)
- Catheters, Indwelling
(adverse effects)
- Critical Illness
- Female
- Humans
- Kaplan-Meier Estimate
- Logistic Models
- Male
- Middle Aged
- Propensity Score
- Proportional Hazards Models
- Renal Dialysis
(adverse effects, instrumentation)
- Renal Replacement Therapy
(adverse effects, instrumentation)
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Time Factors
- United States
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