Incidence and influencing factors associated with exit site infections in temporary catheters for hemodialysis and apheresis.
The authors examined the incidence and influencing actors of exit site infections (ESIs) in patients using dual and triple lumen dialysis catheters. The prospective, randomized study was conducted at 11 centers. Data were analyzed on 473 patients randomized to receive 235 dual lumen catheters (DLCs) or 238 triple lumen catheters (TLCs).


RESULTS
ESIs occurred in 10 patients (2.1%). The number of intertreat-ment uses (p = 0.006), total number of uses (p = 0.009), and catheter placement duration (p = 0.03) were significantly associated with incidence of ESI in both treatment groups. Although patients with TLCs had a significantly higher inter-treatment use than patients with DLCs (p = .04), no sgnificant difference in the incidence of ESI was found (p = 0.11). Diabetic status and catheter insertion site were not found to be significantly related to ESI ( p= 0.09 and p = 0.54, respectively), although a trend toward significance was noted for diabetic status.


CONCLUSIONS
Stringent exit site care by specially trained staff and shorter catheter duration most likely contributed to the low incidence of ESIs. Other influencing factors included numbers of inter-treatment uses, total number of uses, and catheter placement duration.
Young
Elizabeth J
EJ
Vascular Therapy Division, Tyco Healthcare/Kendall, Mansfield, MA, USA.
Contreras
Gabriel
G
Robert
Nurian E
NE
Vogt
Nancy J
NJ
Courtney
Theresa M
TM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001781:Blood Component Removal / Q000295:instrumentation* / Q000592:standards / Q000706:statistics & numerical data*; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000592:standards / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D002985:Clinical Protocols; D003428:Cross Infection / Q000453:epidemiology*; D004867:Equipment Design; D004869:Equipment Safety / Q000706:statistics & numerical data; D005260:Female; D005268:Femoral Vein; D006801:Humans; D015994:Incidence; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation* / Q000592:standards / Q000706:statistics & numerical data*; D012307:Risk Factors; D013350:Subclavian Vein