Occurrence and Risk Factors for Unplanned Central Venous Catheter Removal in Critically Ill Patients: A Multicenter...

Area of Science:

• Critical Care Medicine
• Vascular Access Devices
• Patient Safety

Background:

• Central venous catheters (CVCs) are essential for critically ill patients.
• Unplanned CVC removal can lead to treatment interruption, prolonged hospitalization, and increased mortality.
• Identifying risk factors for unplanned CVC removal is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the incidence and risk factors of unplanned CVC removal in critically ill patients in China.
• To identify patient characteristics and clinical factors associated with premature CVC removal.

Main Methods:

• A multicenter cohort study involving 2680 CVC insertions across 22 tertiary hospitals in China.
• Cox proportional hazards regression models were employed to analyze risk factors for unplanned CVC removal.
• Data were collected from September 4, 2023, to February 29, 2024.

Main Results:

• The incidence of unplanned CVC removal was 5.71%, with infection-related complications being the leading cause (4.63%).
• Independent risk factors for unplanned CVC removal included male gender (HR 2.04), neurological disorders (HR 2.41), and mechanical ventilation (HR 1.71).
• Urgent CVC insertion was found to be a protective factor (HR 0.52).

Conclusions:

• Unplanned CVC removal is a significant concern in critical care, with infection being a primary driver.
• Male gender, neurological disorders, and mechanical ventilation are key risk factors.
• Targeted preventive strategies focusing on these factors and promoting urgent CVC insertion are recommended to reduce unplanned removals.