title: Estimating duration of central venous catheter at time of insertion: Clinician judgment and clinical predictors.
abstract: OBJECTIVE
  The aim of this study was to investigate whether clinicians can estimate the length of time a central venous catheter (CVC) will remain in place and to identify variables that may predict CVC duration.
  
  
  METHODS
  We conducted a prospective study of patients admitted to the intensive care unit over a 1-year period. Clinicians estimated the anticipated CVC duration at time of insertion. We collected demographics, medical history, type of intensive care unit, anatomical site of CVC placement, vital signs, laboratory values, Sequential Organ Failure Assessment score, mechanical ventilation, and use of vasopressors. Pearson correlation coefficient was used to assess the correlation between estimated and actual CVC time. We performed multivariable logistic regression to identify predictors of long duration (>5 days).
  
  
  RESULTS
  We enrolled 200 patients; median age was 65 years (quartiles 52, 75); 91 (46%) were female; and mortality was 24%. Correlation between estimated and actual CVC time was low (r=0.26; r2=0.07; P<.001). Mechanical ventilation (odds ratio, 2.20; 95% confidence interval, 1.22-3.97; P=.009) at time of insertion and a medical history of cancer (odds ratio, 0.35; 95% confidence interval, 0.16-0.75; P=.007) were significantly associated with long duration.
  
  
  CONCLUSIONS
  Our results suggest a low correlation between clinician prediction and actual CVC duration. We did not find any strong predictors of long CVC duration identifiable at the time of insertion.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215; Research Center for Emergency Medicine, Aarhus University Hospital, 8000 Aarhus, Denmark. Electronic address: mathiasjohanholmberg@gmail.com.
authors.forename: Mathias J
authors.initials: MJ
authors.lastname: Holmberg
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215; Department of Anesthesiology, Aarhus University Hospital, 8000 Aarhus, Denmark. Electronic address: lwandersen@clin.au.dk.
authors.forename: Lars W
authors.initials: LW
authors.lastname: Andersen
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215. Electronic address: amandagraver@gmail.com.
authors.forename: Amanda
authors.initials: A
authors.lastname: Graver
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215; Division of Infection Control/Hospital Epidemiology, Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, Boston, MA 02215. Electronic address: sbwright@bidmc.harvard.edu.
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wright
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215; Division of Infection Control/Hospital Epidemiology, Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, Boston, MA 02215. Electronic address: dyassa@bidmc.harvard.edu.
authors.forename: David
authors.initials: D
authors.lastname: Yassa
authors.affiliation: Division of Pulmonary Critical Care, Department of Medicine, University of Chicago, Chicago, IL 60637. Electronic address: mhowell1@medicine.bsd.uchicago.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Howell
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215; Division of Pulmonary Critical Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215. Electronic address: mdonnino@bidmc.harvard.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Donnino
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215; Division of Critical Care, Department of Anesthesia Critical Care, Beth Israel Deaconess Medical Center, Boston, MA 02215. Electronic address: mcocchi@bidmc.harvard.edu.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cocchi
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007600:Judgment; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D013997:Time Factors
keywords: Antimicrobial; Antiseptic; Bloodstream infection; Central venous catheter; Central venous line; Predictor