Bibliographic Details
| Title: |
Development and validation of a multivariable prediction model of central venous catheter-tip colonization in a cohort of five randomized trials |
| Authors: |
Jeanne Iachkine, Niccolò Buetti, Harm-Jan de Grooth, Anaïs R. Briant, Olivier Mimoz, Bruno Mégarbane, Jean-Paul Mira, Stéphane Ruckly, Bertrand Souweine, Damien du Cheyron, Leonard A. Mermel, Jean-François Timsit, Jean-Jacques Parienti |
| Source: |
Critical Care, Vol 26, Iss 1, Pp 1-11 (2022) |
| Publisher Information: |
BMC, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Medical emergencies. Critical care. Intensive care. First aid |
| Subject Terms: |
Catheter-tip colonization, Catheter-related infection, Intensive care unit, Central Venous catheters, Predictive score, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| More Details: |
Abstract Background The majority of central venous catheters (CVC) removed in the ICU are not colonized, including when a catheter-related infection (CRI) is suspected. We developed and validated a predictive score to reduce unnecessary CVC removal. Methods We conducted a retrospective cohort study from five multicenter randomized controlled trials with systematic catheter-tip culture of consecutive CVCs. Colonization was defined as growth of ≥103 colony-forming units per mL. Risk factors for colonization were identified in the training cohort (CATHEDIA and 3SITES trials; 3899 CVCs of which 575 (15%) were colonized) through multivariable analyses. After internal validation in 500 bootstrapped samples, the CVC-OUT score was computed by attaching points to the robust (> 50% of the bootstraps) risk factors. External validation was performed in the testing cohort (CLEAN, DRESSING2 and ELVIS trials; 6848 CVCs, of which 588 (9%) were colonized). Results In the training cohort, obesity (1 point), diabetes (1 point), type of CVC (dialysis catheter, 1 point), anatomical insertion site (jugular, 4 points; femoral 5 points), rank of the catheter (second or subsequent, 1 point) and catheterization duration (≥ 5 days, 2 points) were significantly and independently associated with colonization . Area under the ROC curve (AUC) for the CVC-OUT score was 0.69, 95% confidence interval (CI) [0.67–0.72]. In the testing cohort, AUC for the CVC-OUT score was 0.60, 95% CI [0.58–0.62]. Among 1,469 CVCs removed for suspected CRI in the overall population, 1200 (82%) were not colonized. The negative predictive value (NPV) of a CVC-OUT score |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1364-8535 |
| Relation: |
https://doaj.org/toc/1364-8535 |
| DOI: |
10.1186/s13054-022-04078-x |
| Access URL: |
https://doaj.org/article/2dd94a1527d44a66888bb62752a9b7a7 |
| Accession Number: |
edsdoj.2dd94a1527d44a66888bb62752a9b7a7 |
| Database: |
Directory of Open Access Journals |
