Incidence And Risk Factors For Central Venous Catheter-related Thrombosis In Critically Ill Patients

BackgroundCentral Venous Catheters(CVCs)are widely used in the rapid infusion,blood purification treatment,the monitoring of central venous pressure,parenteral nutrition,etc.While they are widely used in intensive care units,the complications caused by CVCs indwelling are common and can cause various adverse consequences.Among them,Catheter-related thrombosis(CRT)and Catheter-related infection(CRI)are more common.According to the research,the incidence of CVC-related thrombosis is 2%to 67%,of which asymptomatic CRT accounts for about 2/3.Compared with patients without CVCs,patients with PICC had a 3.5-fold increased risk of CRT,and patients with other CVCs had a 2.5-fold increased risk of CRT.With the presence of Catheter-related thrombosis,it can increase hospitalization costs,prolong hospital stays,and may even lead to deep vein thrombosis(DVT),pulmonary embolism(PE),and post-thrombotic syndrome(PTS).It has been reported that among patients with CRT,pulmonary embolism with clinical symptoms is 10%to 25%,and the incidence of pulmonary embolism confirmed by autopsy is as high as 50%.Therefore,this study intends to place CVCs in critically ill patients as subjects,investigates the incidence of CRT,and analyzes the risk factors affecting this complications,in order to the prevention of the CVCs-related complications.HypothesisAge,catheterization,FIB,D-dimer,and APACHE ? may be the risk factors for central venous catheter related thrombosis.Objective1)To investigate the incidence of central venous catheter-related thrombosis(CRT)in critically ill patients,in order to provide basic epidemiological data for CRT prevention;2)To analyze the risk factors of CRT in critically ill patients to provide a theoretical basis for the development of preventive measures.MethodsThis study was a prospective,observational clinical trial conducted.Ethics approval was obtained from the Zhujiang Hospital Medical Research Ethics Committee of Southern Medical University.The trial has been registered with ClinicalTrials.gov registry(NCT 03841240).From August 2018 to April 2019,patients who met the test inclusion criteria were selected in the ICU of Zhujiang Hospital of Southern Medical University.The primary outcome of the study was the incidence of CRT in the ICU.The secondary outcomes was the time when CRT occurred.The timepoints for data collection were the time before CVCs are placed and during CVCs indwelling.ResultsA total of 79 patients met the inclusion criteria,including 30 CRT patients,the incidence rate was 38.0%,52.9/thousand catheter days,CRT occurred in NO.5(1?10)days.The univariate analysis showed that the body temperature,APACHE ?,FIB,catheterization site shown significant differences in the formation of CRT(P<0.05).The multivariate logistic regression analysis showed that body temperature,FIB and APACHE ? were risk factors for CRT(P<0.05).ConclusionThe incidence of central venous catheter-related thrombosis is high in critically ill patients.The occurrence of CRT is closely related to body temperature,fibrinogen,and APACHE ?.