医学
皮肤癌
前瞻性队列研究
入射(几何)
观察研究
静脉通路
中心静脉导管
并发症
队列研究
外科
癌症
急诊医学
导管
重症监护医学
内科学
物理
光学
作者
Nicole Gavin,Sarah Northfield,Gabor Mihala,Margarette Somerville,Tricia Kleidon,Nicole Marsh,Emily Larsen,Jill Campbell,Claire M. Rickard,Amanda Ullman
标识
DOI:10.1016/j.soncn.2024.151618
摘要
To identify the prevalence and type of central venous access device–associated skin complications for adult cancer patients, describe central venous access device management practices, and identify clinical and demographic characteristics associated with risk of central venous access device–associated skin complications. A prospective cohort study of 369 patients (626 central venous access devices; 7,682 catheter days) was undertaken between March 2017 and March 2018 across two cancer care in-patient units in a large teaching hospital. Twenty-seven percent (n = 168) of participants had a central venous access device–associated skin complication. In the final multivariable analysis, significant (P < .05) risk factors for skin complications were cutaneous graft versus host disease (2.1 times greater risk) and female sex (1.4 times greater risk), whereas totally implanted vascular access device reduced risk for skin complications by two-thirds (incidence risk ratio 0.37). Central venous access device–associated skin complications are a significant, potentially avoidable injury, requiring cancer nurses to be aware of high-risk groups and use evidence-based preventative and treatment strategies. This study has confirmed how common these potentially preventable injuries are. Therefore, the prevalence of these complications could be reduced by focusing on improvements in skin assessment, reductions in central venous access device dressing variation and improving clinician knowledge of this injury.
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