Morbidity associated with central venous catheter-use in a cohort of 212 hospitalized subjects with HIV infection.
Technical complications and nosocomial bloodstream infections associated with short-term central venous catheterization remain a heavy burden in terms of morbidity, mortality and cost in HIV-positive subjects. Between 1994 and 1997, 327 central venous catheters (CVCs) inserted in 212 patients for a total of 5005 catheter days were investigated. Forty-two technical complications (13%) occurred in 40 patients. Logistic regression analysis revealed that a high APACHE III score was associated with development of CVC-related complications (P = 0.01). One hundred and eight of 327 CVCs (33%) were suspected as being infected. However only 61 episodes (61/327, 19%) were finally diagnosed as CVC-related sepsis. Three variables affecting the rate of CVC-related sepsis were identified: 1) administration of TPN (P = 0.01); 2) low number of circulating CD4+ cells (P = 0.04); 3) high APACHE III score (P = 0. 04). Doctors responsible for AIDS patients should carefully consider the relative risks and benefits of CVC insertion in an individual patient.
Tacconelli
E
E
Department of Infectious Diseases, Catholic University, Rome, Italy. etaccon@tin.it
Tumbarello
M
M
de Gaetano Donati
K
K
Bertagnolio
S
S
Pittiruti
M
M
Leone
F
F
Morace
G
G
Cauda
R
R
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D018806:APACHE; D000328:Adult; D018791:CD4 Lymphocyte Count; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D004868:Equipment Failure; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality