Bleeding assessment following central venous catheter placement, a direct comparison of prospective and retrospective analyses.

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Title: Bleeding assessment following central venous catheter placement, a direct comparison of prospective and retrospective analyses.
Authors: van Baarle, Floor L. F., van de Weerdt, Emma K., Raasveld, S. Jorinde, Vlaar, Alexander P. J., Biemond, Bart J., van der Velden, Walter J. F. M., Ruiterkamp, Roelof A., Tuinman, Pieter R., Ypma, Paula F., van den Bergh, Walter M., Demandt, Astrid M. P., Kerver, Emile D., Jansen, A. J. Gerard, Westerweel, Peter E., Arbous, M. Sesmu, Determann, Rogier M., van Mook, Walther N. K. A., Koeman, Mirelle, Mäkelburg, Anja B. U., van Lienden, Krijn P.
Source: Transfusion; Aug2024, Vol. 64 Issue 8, p1414-1420, 7p
Subject Terms: CENTRAL venous catheterization, CENTRAL venous catheters, INTER-observer reliability, ODDS ratio, RETROSPECTIVE studies
Abstract: Background: Reported bleeding incidences following central venous catheter (CVC) placement highly depend on methods of bleeding assessment. To determine the direction and magnitude of the bias associated with retrospective data collection, we used data from the PACER randomized controlled trial and a previous retrospective cohort study. Study Design and Methods: A patient‐level comparison of CVC‐related bleeding severity was made among (1) the prospectively collected clinical bleeding assessment of the PACER trial, (2) centralized assessment of CVC insertion site photographs, and (3) retrospective chart review. Interrater reliability for photographic bleeding assessment and retrospective chart review was assessed using Cohen's κ. The magnitude of underreporting of both methods compared to prospective clinical bleeding assessment at different cutoff points of clinically relevant bleeding was assessed using McNemar's test. Results: Interrater reliability was acceptable for both methods (κ = 0.583 and κ = 0.481 for photographic assessment and retrospective chart review, respectively). Photographic bleeding assessment led to significant underreporting of bleeding complications at all cutoff points. Retrospective chart review led to significant underreporting of minor bleeding complications, with an odds ratio (95% CI) of 0.17 (0.044–0.51) for the cutoff point grade 1 (i.e., self‐limiting or requiring at most 20 min of manual compression) or higher. There was no significant underreporting of major bleeding complications with retrospective chart review. Discussion: Centralized photographic bleeding assessment and retrospective chart review lead to biased bleeding assessment compared to prospective clinical bleeding assessment. [ABSTRACT FROM AUTHOR]
Copyright of Transfusion is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Complementary Index
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  Data: Bleeding assessment following central venous catheter placement, a direct comparison of prospective and retrospective analyses.
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  Data: Transfusion; Aug2024, Vol. 64 Issue 8, p1414-1420, 7p
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  Data: <searchLink fieldCode="DE" term="%22CENTRAL+venous+catheterization%22">CENTRAL venous catheterization</searchLink><br /><searchLink fieldCode="DE" term="%22CENTRAL+venous+catheters%22">CENTRAL venous catheters</searchLink><br /><searchLink fieldCode="DE" term="%22INTER-observer+reliability%22">INTER-observer reliability</searchLink><br /><searchLink fieldCode="DE" term="%22ODDS+ratio%22">ODDS ratio</searchLink><br /><searchLink fieldCode="DE" term="%22RETROSPECTIVE+studies%22">RETROSPECTIVE studies</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Reported bleeding incidences following central venous catheter (CVC) placement highly depend on methods of bleeding assessment. To determine the direction and magnitude of the bias associated with retrospective data collection, we used data from the PACER randomized controlled trial and a previous retrospective cohort study. Study Design and Methods: A patient‐level comparison of CVC‐related bleeding severity was made among (1) the prospectively collected clinical bleeding assessment of the PACER trial, (2) centralized assessment of CVC insertion site photographs, and (3) retrospective chart review. Interrater reliability for photographic bleeding assessment and retrospective chart review was assessed using Cohen's κ. The magnitude of underreporting of both methods compared to prospective clinical bleeding assessment at different cutoff points of clinically relevant bleeding was assessed using McNemar's test. Results: Interrater reliability was acceptable for both methods (κ = 0.583 and κ = 0.481 for photographic assessment and retrospective chart review, respectively). Photographic bleeding assessment led to significant underreporting of bleeding complications at all cutoff points. Retrospective chart review led to significant underreporting of minor bleeding complications, with an odds ratio (95% CI) of 0.17 (0.044–0.51) for the cutoff point grade 1 (i.e., self‐limiting or requiring at most 20 min of manual compression) or higher. There was no significant underreporting of major bleeding complications with retrospective chart review. Discussion: Centralized photographic bleeding assessment and retrospective chart review lead to biased bleeding assessment compared to prospective clinical bleeding assessment. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Transfusion is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/trf.17930
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        Text: English
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