TY - JOUR
T1 - Long-term central venous access in a pediatric leukemia population
AU - Fu, Aurelia B.
AU - Hodgman, Erica I.
AU - Burkhalter, Lorraine S.
AU - Renkes, Rachel
AU - Slone, Tamra
AU - Alder, Adam C.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Central venous access devices (CVADs) play an important role in the management of pediatric oncology patients; unfortunately, they are also associated with potentially serious complication rates. We hypothesized that, despite the significantly different disease courses typical of acute lymphoblastic leukemia and acute myelogenous leukemia, there would be identifiable risk factors for premature CVAD removal. Methods We retrospectively studied clinical characteristics and procedure records for all patients admitted with a leukemia diagnosis at our institution from May 2009 to July 2014. Results Our observed perioperative complication rate was 6%; over 70% of lines had at least one long-term complication (thrombosis, catheter-related bloodstream infection, or unexplained line malfunction). Obesity (odds ratio [OR], 6.9; 95% CI, 1.62-29.43), preoperative dosage of packed red blood cells (in mL/kg; OR, 3.13; 1.07-9.21), bloodstream infection (OR, 5.75; 1.69-19.56) were associated with increased risk of premature catheter removal; unexplained malfunction was associated with a lower risk (OR, 0.28; 0.09-0.93). Conclusions Obesity, the preoperative dosage of packed red blood cells, the presence of a bloodstream infection, and unexplained line malfunction are significant predictors of premature CVAD removal in a pediatric leukemia population.
AB - Background Central venous access devices (CVADs) play an important role in the management of pediatric oncology patients; unfortunately, they are also associated with potentially serious complication rates. We hypothesized that, despite the significantly different disease courses typical of acute lymphoblastic leukemia and acute myelogenous leukemia, there would be identifiable risk factors for premature CVAD removal. Methods We retrospectively studied clinical characteristics and procedure records for all patients admitted with a leukemia diagnosis at our institution from May 2009 to July 2014. Results Our observed perioperative complication rate was 6%; over 70% of lines had at least one long-term complication (thrombosis, catheter-related bloodstream infection, or unexplained line malfunction). Obesity (odds ratio [OR], 6.9; 95% CI, 1.62-29.43), preoperative dosage of packed red blood cells (in mL/kg; OR, 3.13; 1.07-9.21), bloodstream infection (OR, 5.75; 1.69-19.56) were associated with increased risk of premature catheter removal; unexplained malfunction was associated with a lower risk (OR, 0.28; 0.09-0.93). Conclusions Obesity, the preoperative dosage of packed red blood cells, the presence of a bloodstream infection, and unexplained line malfunction are significant predictors of premature CVAD removal in a pediatric leukemia population.
KW - Central venous catheter
KW - Complications
KW - Pediatric
KW - Vascular access
UR - http://www.scopus.com/inward/record.url?scp=84980368172&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84980368172&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2016.06.052
DO - 10.1016/j.jss.2016.06.052
M3 - Article
C2 - 27664891
AN - SCOPUS:84980368172
SN - 0022-4804
VL - 205
SP - 419
EP - 425
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 2
ER -