OBJECTIVE: To explore the impact of retention of non-tunneled central venous catheters (CVCs) on survival in candidemic cancer patients, where CVCs are commonly used and essential. A second object was to determine whether early CVC removal would benefit a subset of cancer patients. METHODS: We retrospectively evaluated 92 cancer patients who had a single, non-tunneled CVC in place. Patients were grouped according to CVC retention or removal; the later group was subdivided into early (CVC removed <or=72h after candidemia onset) and late removal. A Cox regression model was used for determining risk factors of adverse outcome and Kaplan-Meier analyses for comparing in-hospital 3-30 day survival among subgroups. RESULTS: Baseline characteristics were comparable between CVC retention (n=20) or removal (n=72) groups. CVC retention was a significant risk factor of poor outcome, independent of other significant prognostic host factors (hazard ratio 7.15, 95% confidence interval 3.51-14.53, p<0.001). Patients of early CVC removal (n=40) had significant better survival than those of late removal (n=32) (p<0.001). CONCLUSION: The results suggest that retention of CVCs has a negative impact on survival in candidemic cancer patients, and that early CVC removal should be considered in a subset of cancer patients with candidemia.
OBJECTIVE: To explore the impact of retention of non-tunneled central venous catheters (CVCs) on survival in candidemic cancerpatients, where CVCs are commonly used and essential. A second object was to determine whether early CVC removal would benefit a subset of cancerpatients. METHODS: We retrospectively evaluated 92 cancerpatients who had a single, non-tunneled CVC in place. Patients were grouped according to CVC retention or removal; the later group was subdivided into early (CVC removed <or=72h after candidemia onset) and late removal. A Cox regression model was used for determining risk factors of adverse outcome and Kaplan-Meier analyses for comparing in-hospital 3-30 day survival among subgroups. RESULTS: Baseline characteristics were comparable between CVC retention (n=20) or removal (n=72) groups. CVC retention was a significant risk factor of poor outcome, independent of other significant prognostic host factors (hazard ratio 7.15, 95% confidence interval 3.51-14.53, p<0.001). Patients of early CVC removal (n=40) had significant better survival than those of late removal (n=32) (p<0.001). CONCLUSION: The results suggest that retention of CVCs has a negative impact on survival in candidemic cancerpatients, and that early CVC removal should be considered in a subset of cancerpatients with candidemia.
Authors: S Arias; O Denis; I Montesinos; S Cherifi; V Y Miendje Deyi; F Zech Journal: Eur J Clin Microbiol Infect Dis Date: 2016-11-10 Impact factor: 3.267
Authors: K M T Astvad; H K Johansen; B L Røder; F S Rosenvinge; J D Knudsen; L Lemming; H C Schønheyder; R K Hare; L Kristensen; L Nielsen; J B Gertsen; E Dzajic; M Pedersen; C Østergård; B Olesen; T S Søndergaard; M C Arendrup Journal: J Clin Microbiol Date: 2018-03-26 Impact factor: 5.948
Authors: Peter G Pappas; Carol A Kauffman; David R Andes; Cornelius J Clancy; Kieren A Marr; Luis Ostrosky-Zeichner; Annette C Reboli; Mindy G Schuster; Jose A Vazquez; Thomas J Walsh; Theoklis E Zaoutis; Jack D Sobel Journal: Clin Infect Dis Date: 2015-12-16 Impact factor: 9.079