title: Propensity score analysis confirms the independent effect of parenteral nutrition on the risk of central venous catheter-related bloodstream infection in oncological patients.
abstract: OBJECTIVE
  Parenteral nutrition is known as a high-risk factor for central venous catheter-related bloodstream infection (CVC-RBSI) in cancer patients. Owing to ethical and technical problems, the studies in the literature have nonrandomized designs and are therefore often confounded by biases. We performed a propensity score analysis to estimate the effect of parenteral nutrition on CVC-RBSI in digestive cancer patients who underwent chemotherapy.
  
  
  METHODS
  Data were collected prospectively. A logistic regression model was used to calculate a propensity score, which was the probability of receiving parenteral nutrition. Kaplan-Meier survival and Cox regression model were used to estimate the effect of the parenteral nutrition on CVC-RBSI after adjustment for the propensity score.
  
  
  RESULTS
  Before the propensity score analysis, the differences between patients with (n = 113) and without (n = 312) parenteral nutrition were identified including: male gender, body weight, weight loss, performance status, location of primary cancer, FOLFIRI, and previous long-term corticotherapy. After propensity score stratification, all of the covariates were balanced within each stratum. After adjustment, patients with parenteral nutrition were at a higher risk for CVC-RBSI.
  
  
  CONCLUSIONS
  By using the propensity score analysis, this study confirmed that parenteral nutrition was an independent risk factor for CVC-RBSI in digestive cancer patients.
authors: Inserm Unit 1060/Inra 1235, University of Lyon, Lyon, France; Clinical Nutrition Intensive Care Unit, Croix Rousse Hospital, Hospices Civils of Lyon, 69004 Lyon, France. Electronic address: abdoulayek2002@yahoo.fr.
authors: Abdoulaye
authors: A
authors: Touré
authors: Cécile
authors: C
authors: Chambrier
authors: Philippe
authors: P
authors: Vanhems
authors: Catherine
authors: C
authors: Lombard-Bohas
authors: Jean-Christophe
authors: JC
authors: Souquet
authors: René
authors: R
authors: Ecochard
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000209:etiology / Q000473:pathology*; D062905:Central Venous Catheters / Q000009:adverse effects*; D004067:Digestive System Neoplasms / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D057216:Propensity Score; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
keywords: Adjustment; Cancer; Catheter-related infection; Nonrandomised study; Parenteral nutrition; Propensity score