Precurved non-tunnelled catheters for haemodialysis are comparable in terms of infections and malfunction as compared to tunnelled catheters: A retrospective cohort study. Issue 3 (May 2019)

• Record Type: Journal Article
• Authors: van Oevelen, Mathijs; Abrahams, Alferso C; Weijmer, Marcel C; Nagtegaal, Tjerko; Dekker, Friedo W; Rotmans, Joris I; Meijvis, Sabine CA
• Other Names: Bijlsma J.A. non-byline-author.; van der Bogt K.E.A. non-byline-author.; van de Brug A. non-byline-author.; Douma C.E. non-byline-author.; Hoorn E.J. non-byline-author.; IJpelaar D.H.T. non-byline-author.; Krol-van Straaten M.J. non-byline-author.; Mui K.W. non-byline-author.; Tordoir J.H.M. non-byline-author.; Vincent H.H. non-byline-author.; Zonnebeld N. non-byline-author.
• Is Part Of: Journal of vascular access. Volume 20:Issue 3(2019)
• Page Start: 307
• Page End: 312
• Publication Date: 2019-05
• Subjects: Haemodialysis -- infections -- catheter -- complications -- vascular access; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/1129729818805954
• Languages: English
• ISSNs: 1129-7298

Abstract

Background: The main limitations of central venous catheters for haemodialysis access are infections and catheter malfunction. Our objective was to assess whether precurved non-tunnelled central venous catheters are comparable to tunnelled central venous catheters in terms of infection and catheter malfunction and to assess whether precurved non-tunnelled catheters are superior to straight catheters. Materials and methods: In this retrospective, observational cohort study, adult patients in whom a central venous catheter for haemodialysis was inserted between 2012 and 2016 were included. The primary endpoint was a combined endpoint consisting of the first occurrence of either an infection or catheter malfunction. The secondary endpoint was a combined endpoint of the removal of the central venous catheter due to either an infection or a catheter malfunction. Using multivariable analysis, cause-specific hazard ratios for endpoints were calculated for tunnelled catheter versus precurved non-tunnelled catheter, tunnelled catheter versus non-tunnelled catheter, and precurved versus straight non-tunnelled catheter. Results: A total of 1603 patients were included. No difference in reaching the primary endpoint was seen between tunnelled catheters, compared to precurved non-tunnelled catheters (hazard ratio, 0.91; 95% confidence interval, 0.70–1.19, p = 0.48). Tunnelled catheters were removed less often, compared to precurved non-tunnelled catheters (hazard ratio, 0.65; 95% confidence interval, 0.46–0.93; p = 0.02). A trend for less infections and catheter malfunctions was seen in precurved jugular non-tunnelled catheters compared to straight non-tunnelled catheters (hazard ratio, 0.60; 95% confidence interval, 0.24–1.50; p = 0.28) and were removed less often (hazard ratio, 0.41; 95% confidence interval, 0.18–0.93; p = 0.03). Conclusion: Tunnelled central venous catheters and precurved non-tunnelled central venous catheters showed no difference in reaching the combined endpoint of catheter-related infections and catheter malfunction. Tunnelled catheters get removed less often because of infection/malfunction than precurved non-tunnelled catheters.