ObjectiveTo analyze and discuss the importance of non-catheter-related hospital infection in intensive care unit (ICU). MethodA prospective target monitoring of all the patients in the general ICU was carried out from January 2011 to December 2013. The hospital infection cases grouped by infection types were analyzed with SPSS 17.0. ResultsA total of 5 364 patients were monitored, 455 of whom had hospital infections totaled 616 times. The hospital infection rate was 11.5%. The amount and constituent ratio of the catheter-related infections showed a declining trend year by year, while the non-catheter-related infections revealed an escalating trend year by year. In these 455 patients, the mixed infection group had the longest hospital stay, followed by the catheter-related infection group and the non-catheter-related infection group (P<0.05). The catheter-related infection group had higher crude mortality rate than both of the mixed infection group and the non-catheter-related infection group (P<0.017). ConclusionsNon-catheter-related infections which get higher and higher proportion in ICU hospital infections should be paid more attention to, while catheter-related infections which could prolong hospitalization and increase the risk of death in ICU patients, remain the focus of the target monitoring of hospital infection in ICU.
Objective To evaluate the associations of the tip position of right femoral tunneled cuffed hemodialysis catheters with primary catheter patency and catheter-related complications. Methods This single-center retrospective cohort study included maintenance hemodialysis patients who underwent right femoral tunneled cuffed catheter (TCC) placement at the Hospital of Chengdu University of Traditional Chinese Medicine between August 2019 and August 2024. Catheter tip position was determined by postprocedural venography or fluoroscopy and classified as the inferior vena cava (IVC) group (catheter tip positioned within the lumen of the IVC) or the non-IVC group (atheter tip located in the iliac vein or more distal veins). Propensity score matching at a 1∶1 ratio was performed using age, sex, and dialysis vintage as covariates; catheter length distribution was compared after matching. Follow-up data were obtained from outpatient and inpatient records, dialysis-center records, imaging data, and telephone follow-up. The primary outcome (primary catheter patency) and secondary outcomes (catheter dysfunction and catheter-related complications) were compared between the two groups. Results A total of 66 patients were included. After matching, 26 patients were included in each group. In the non-IVC group, 18 patients (69.2%) used 23-cm catheters and 8 (30.8%) used 28-cm catheters; in the IVC group, 10 patients (38.5%) used 23-cm catheters and 16 (61.5%) used 28-cm catheters, and the difference was statistically significant (χ2=4.950, P=0.026). Primary patency did not differ significantly at 1 month (96.2% vs. 100.0%, P=1.000), whereas the IVC group had higher primary patency at 3, 6, and 12 months than the non-IVC group (88.5% vs. 61.5%, P=0.025; 80.8% vs. 50.0%, P=0.020; 57.7% vs. 23.1%, P=0.011). Kaplan-Meier analysis showed a significant difference in dysfunction-free catheter survival between groups (log-rank P=0.013). Catheter-related thrombosis, central venous stenosis, and catheter-related infection did not differ significantly between groups (P>0.05). Multivariable Cox regression showed that height ≥169 cm was a risk factor for catheter dysfunction [hazard ratio (HR)=6.06, 95% confidence interval (CI) (2.02, 18.16), P=0.001], whereas catheter tip placement in the IVC was protective [HR=0.30, 95%CI (0.12, 0.72), P=0.008]. Conclusion In patients receiving right femoral TCCs, tip placement in the IVC may improve primary catheter patency and reduce catheter dysfunction; further prospective multicenter studies with larger samples are needed.