Precurved non-tunnelled catheters for haemodialysis are comparable in terms of infections and malfunction as compared to tunnelled catheters: A retrospective cohort study

Mathijs van Oevelen, Alferso C. Abrahams, Marcel C. Weijmer, Tjerko Nagtegaal, Friedo W. Dekker, Joris Rotmans, Sabine C. A. Meijvis*, J. A. Bijlsma, K. E. A. van der Bogt, A. van de Brug, C. E. Douma, E. J. Hoorn, D. H. T. IJpelaar, M. J. Krol-van Straaten, K. W. Mui, J. H. M. Tordoir, H. H. Vincent, N. Zonnebeld, DUCATHO study group collaborators

*Corresponding author for this work

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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.

Original languageEnglish
Pages (from-to)307-312
Number of pages6
JournalJournal of vascular access
Volume20
Issue number3
DOIs
Publication statusPublished - May 2019

Keywords

  • Haemodialysis
  • infections
  • catheter
  • complications
  • vascular access
  • RISK-FACTORS
  • ASH SPLIT
  • BACTEREMIA
  • DIALYSIS
  • DESIGN
  • ACCESS

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