@article{6945fb0ff83d422789b45984f61d94d3,
title = "Precurved non-tunnelled catheters for haemodialysis are comparable in terms of infections and malfunction as compared to tunnelled catheters: A retrospective cohort study",
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.",
keywords = "Haemodialysis, infections, catheter, complications, vascular access, RISK-FACTORS, ASH SPLIT, BACTEREMIA, DIALYSIS, DESIGN, ACCESS",
author = "{van Oevelen}, Mathijs and Abrahams, {Alferso C.} and Weijmer, {Marcel C.} and Tjerko Nagtegaal and Dekker, {Friedo W.} and Joris Rotmans and Meijvis, {Sabine C. A.} and Bijlsma, {J. A.} and {van der Bogt}, {K. E. A.} and {van de Brug}, A. and Douma, {C. E.} and Hoorn, {E. J.} and IJpelaar, {D. H. T.} and {Krol-van Straaten}, {M. J.} and Mui, {K. W.} and Tordoir, {J. H. M.} and Vincent, {H. H.} and N. Zonnebeld and {DUCATHO study group collaborators}",
note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Dutch Kidney Foundation (grant A2D5P02). The funders played no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. Funding Information: A.A., J.R. and S.M. designed the study. M.O. and T.N. acquisitioned the data. M.O. and S.M. analysed the data. F.D. supervised the statistical analysis. M.O., M.W. and S.M. wrote the manuscript. All authors discussed and commented on the final manuscript. DUCATHO study group collaborators: J.A. Bijlsma (Dianet, Amsterdam, The Netherlands), K.E.A. van der Bogt (Haaglanden Medical Center, Den Haag, The Netherlands), A. van de Brug (University Medical Center Utrecht, Utrecht, The Netherlands), C.E. Douma (Spaarne Gasthuis, Hoofddorp, The Netherlands), E.J. Hoorn (Erasmus Medical Center, Rotterdam, The Netherlands), D.H.T. IJpelaar (Groene Hart Hospital, Gouda, The Netherlands), M.J. Krol-van Straaten (HagaZiekenhuis, Den Haag, The Netherlands), K.W. Mui (Hospital St. Jansdal, Harderwijk, The Netherlands), J.H.M. Tordoir (Maastricht University Medical Center, Maastricht, The Netherlands), H.H. Vincent (St. Antonius Hospital, Nieuwegein, The Netherlands), N. Zonnebeld (Maastricht University Medical Center, Maastricht, The Netherlands) The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Dutch Kidney Foundation (grant A2D5P02). The funders played no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. Publisher Copyright: {\textcopyright} The Author(s) 2018.",
year = "2019",
month = may,
doi = "10.1177/1129729818805954",
language = "English",
volume = "20",
pages = "307--312",
journal = "Journal of vascular access",
issn = "1129-7298",
publisher = "SAGE Publications Ltd",
number = "3",
}