Parenteral nutrition as a risk factor for central venous catheter-related infection.
BACKGROUND
The role of parenteral nutrition (PN) therapy as an independent risk factor for central venous catheter (CVC)-related infection in nonselected adult patients is not well established. The aim of this study was to evaluate PN as a risk factor for central venous catheter-related infection in nonselected adult patients in a general university hospital.


METHODS
Patients using central venous catheters, exposed or nonexposed to PN, were prospectively followed for development of central venous catheter-related infection.


RESULTS
One hundred fifty-three patients were studied; 28 developed central venous catheter-related infection. Patients with central venous catheter-related infection presented higher frequency of PN use than patients without infection (60.7 vs 34.4%; p = .010). Multivariate Cox analysis showed that PN (relative risk (RR) = 3.30; 95% confidence interval [CI], 1.30-8.34; p = .012) was the only risk factor for central venous catheter-related infection. Malnutrition (RR = 0.45; 95% CI, 0.15-1.34; p = .152), days of hospitalization before central venous catheter insertion (RR = 1.00; 95% CI, 0.98-1.02; p = .801), and sustained hyperglycemia (RR = 0.49; 95% CI, 0.98-1.21; p = .091) were not significant in the model. Multiple logistic regression revealed that mal-nutrition (odds ratio [OR] = 8.05; 95% CI, 1.85-35.03; p = .005), central venous catheter indication for surgical-related pathology (OR = 7.26; 95% CI, 2.51-21.04; p < .001), sustained hyperglycemia (OR = 4.34; 95% CI, 1.79-10.52; p = .001), and days of hospitalization before central venous catheter insertion (OR = 1.04; 95% CI, 1.01-1.07; p = .004) were associated with PN use after adjustment for Assessment Score Intervention System score (OR = 0.33; 95% CI, 0.14-0.80; p = .014).


CONCLUSIONS
PN therapy is an independent risk factor for central venous catheter-related infection in nonselected hospitalized adult patients.
Beghetto
Mariur G
MG
Nursing Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2350, 90035-003 Porto Alegre, RS, Brazil.
Victorino
Josué
J
Teixeira
Luciana
L
de Azevedo
Mirela J
MJ
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D015331:Cohort Studies; D016001:Confidence Intervals; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000453:epidemiology* / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010288:Parenteral Nutrition / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors