The journal of vascular access · 2025
Design features, associated risks, and usage trends of non-tunneled hemodialysis catheters: A retrospective evaluation of dual and triple lumen devices.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Miller George, Zabaleta Isabella, Ogujiofor Kingsley, Fatima Rukhaiya, Albrecht Emma, Warden Madalyn
Аннотация
INTRODUCTION: Non-tunneled short-term hemodialysis (STHD) catheters are essential for managing acute kidney injury (AKI) and other conditions requiring temporary vascular access. Despite their widespread use, these catheters carry inherent risks, including infection and mechanical complications. This study evaluates the impact of catheter design features, such as lumen number, material, and configuration, on infection-related events in STHD catheters.
METHODS: A retrospective analysis was conducted using de-identified medical records from the Truveta database, comprising 3546 catheter insertions from 3240 unique patients between 2011 and 2023. Logistic regression models were employed to assess the relationship between catheter characteristics (e.g. lumen number, material) and infection-related events within 14 days of placement. Descriptive statistics and trending data from 2018 to 2022 were also analyzed.
FINDINGS: Triple-lumen catheters were significantly associated with an increased risk of infection-related events compared to dual-lumen catheters (aOR: 1.54, 95% CI: 1.12-2.14, p < 0.01). Female patients had a lower risk of infection (aOR: 0.61, 95% CI: 0.46-0.81, p < 0.01), while Black patients had a higher risk (aOR: 1.43, 95% CI: 1.00-2.03, p = 0.04). However, trending data revealed that while the use of triple-lumen catheters increased from 29% in 2018 to 68% in 2022, infection rates for these catheters decreased from 18% to 7% during the same period.
DISCUSSION: Triple-lumen catheters were associated with a higher risk of infection, but their increasing use over time coincided with a decline in infection rates. Further research is needed to confirm these findings and explore the mechanisms underlying demographic and design-related infection risks.
METHODS: A retrospective analysis was conducted using de-identified medical records from the Truveta database, comprising 3546 catheter insertions from 3240 unique patients between 2011 and 2023. Logistic regression models were employed to assess the relationship between catheter characteristics (e.g. lumen number, material) and infection-related events within 14 days of placement. Descriptive statistics and trending data from 2018 to 2022 were also analyzed.
FINDINGS: Triple-lumen catheters were significantly associated with an increased risk of infection-related events compared to dual-lumen catheters (aOR: 1.54, 95% CI: 1.12-2.14, p < 0.01). Female patients had a lower risk of infection (aOR: 0.61, 95% CI: 0.46-0.81, p < 0.01), while Black patients had a higher risk (aOR: 1.43, 95% CI: 1.00-2.03, p = 0.04). However, trending data revealed that while the use of triple-lumen catheters increased from 29% in 2018 to 68% in 2022, infection rates for these catheters decreased from 18% to 7% during the same period.
DISCUSSION: Triple-lumen catheters were associated with a higher risk of infection, but their increasing use over time coincided with a decline in infection rates. Further research is needed to confirm these findings and explore the mechanisms underlying demographic and design-related infection risks.