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Open Access 01-12-2021 | Central Venous Catheter | Research

Practices and intravascular catheter infection during on- and off-hours in critically ill patients

Authors: Niccolò Buetti, Stéphane Ruckly, Jean-Christophe Lucet, Arthur Mageau, Claire Dupuis, Bertrand Souweine, Olivier Mimoz, Jean-François Timsit

Published in: Annals of Intensive Care | Issue 1/2021

Abstract

Background

The potential relationship between intravascular catheter infections with their insertion during weekend or night-time (i.e., off-hours or not regular business hours) remains an open issue. Our primary aim was to describe differences between patients and catheters inserted during on- versus off-hours. Our secondary aim was to investigate whether insertions during off-hours influenced the intravascular catheter infectious risks.

Methods

We performed a post hoc analysis using the databases from four large randomized-controlled trials. Adult patients were recruited in French ICUs as soon as they required central venous catheters or peripheral arterial (AC) catheter insertion. Off-hours started at 6 P.M. until 8:30 A.M. during the week; at weekend, we defined off-hours from 1 P.M. on Saturday to 8.30 A.M. on Monday. We performed multivariable marginal Cox models to estimate the effect of off-hours (versus on-hours) on major catheter-related infections (MCRI) and catheter-related bloodstream infections (CRBSIs).

Results

We included 7241 patients in 25 different ICUs, and 15,208 catheters, including 7226 and 7982 catheters inserted during off- and on-hours, respectively. Catheters inserted during off-hours were removed after 4 days (IQR 2, 9) in median, whereas catheters inserted during on-hours remained in place for 6 days (IQR 3,10; p < 0.01) in median. Femoral insertion was more frequent during off-hours. Among central venous catheters and after adjusting for well-known risk factors for intravascular catheter infection, we found a similar risk between off- and on-hours for MCRI (HR 0.91, 95% CI 0.61–1.37, p = 0.65) and CRBSI (HR 1.05, 95% CI 0.65–1.68, p = 0.85). Among central venous catheters with a dwell-time > 4 or > 6 days, we found a similar risk for MCRI and CRBSI between off- and on-hours. Similar results were observed for ACs.

Conclusions

Off-hours did not increase the risk of intravascular catheter infections compared to on-hours. Off-hours insertion is not a sufficient reason for early catheter removal, even if femoral route has been selected.

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Title: Practices and intravascular catheter infection during on- and off-hours in critically ill patients
Authors: Niccolò Buetti
Stéphane Ruckly
Jean-Christophe Lucet
Arthur Mageau
Claire Dupuis
Bertrand Souweine
Olivier Mimoz
Jean-François Timsit
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keyword: Central Venous Catheter
Published in: Annals of Intensive Care / Issue 1/2021
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-021-00940-3

2024 ASCO Annual Meeting

Springer Medicine

Practices and intravascular catheter infection during on- and off-hours in critically ill patients

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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