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Enfermería Nefrológica
versão On-line ISSN 2255-3517versão impressa ISSN 2254-2884
Resumo
SANCHEZ VILLAR, Isidro e LORENZO SELLARES, Víctor. Are tunneled catheters for hemodialysis more infected when patients are admitted to the hospital?. Enferm Nefrol [online]. 2019, vol.22, n.3, pp.266-273. Epub 23-Dez-2019. ISSN 2255-3517. https://dx.doi.org/10.4321/s2254-28842019000300005.
Infection of catheters for hemodialysis is one of the major causes of morbidity and mortality. The intuitive hypothesis that catheters become more infected during hospitalization has not been verified in the literature.
Objective
To know if hospitalization is a risk factor for catheter-related bacteraemia.
Material and Method: Retrospective analysis of catheter-associated bacteraemias in dialysis center dependent on a Nephrology Department of a third level hospital during the 2014-2017 period.
Catheter use times and catheter-related bacteraemias were divided into 2 scenarios: hospital and dialysis center.
The Poisson Regression Model was applied to compare bacteremia in hospital and dialysis center. The same patient could suffer bacteremia more than once and in both scenarios.
Results
361 catheters were used in 174 patients with a total time of use of 91,491 days, with 103 episodes of bacteraemia.
Bacteremia rates
in hospital was 7.81/1000 days/catheter and in dialysis center was 0.81/1000 days/catheter.
The risk of bacteraemia was multiplied by 9.6 during hospitalization versus dialysis center (p <0.001).
Conclusions
The risk of catheter-related bacteraemia increases when patients are hospitalized. Circumstances related to hospitalization are risk factors. Although the greater comorbidity of these patients may partly explain the higher incidence of bacteraemias, the optimization of nursing care -for uninhabited personnel- is the focus of improvement, according to our results.
Palavras-chave : hemodialysis; central venous catheter; bacteraemia; hospitalization.
