Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jul 9, 2021; 10(4): 120-131
Published online Jul 9, 2021. doi: 10.5492/wjccm.v10.i4.120
Emergency service results of central venous catheters: Single center, 1042 patients, 10-year experience
Abuzer Coskun, Sakir Ömür Hıncal, Sevki Hakan Eren
Abuzer Coskun, Sakir Ömür Hıncal, Emergency Medicine Clinic, SBU Istanbul Bağcılar Training and Research Hospital, Istanbul 34200, Turkey
Sevki Hakan Eren, Department of Emergency, Gaziantep University Medical Faculty, Gaziantep 27410, Turkey
Author contributions: Coskun A and Eren SH contributed to study design, concept, writing the manuscript, and revising the final form; Coskun A and Hıncal SÖ contributed to data collection and manuscript revision; all authors contributed to writing and discussion management; all authors contributed to data management and manuscript revision, data collection, interpretation of data, and revising of the manuscript; Coskun A contributed to data collection and revision; Hıncal SÖ contributed to data collection and statistical analysis; Eren SH contributed to critical revision; Coskun A suggested the idea, as a chair of the department provided general support and substantial contribution to concept and design, and acquisition of data; all authors read and approved the final manuscript.
Institutional review board statement: Ethical approval was obtained from the Local Ethics Committee of Cumhuriyet University Faculty of Medicine with the date of 04/12/2012 and the decision number of 08/12/2012.
Informed consent statement: The studied group as the study was retrospective in nature, and no specific intervention was described by the author’s methodology. The medical research center waived the informed consent for the project.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abuzer Coskun, MD, Associate Professor, Doctor, Emergency Medicine Clinic, SBU Istanbul Bağcılar Training and Research Hospital, Central Quarter Dr. Sadık Ahmet Street, Bağcılar, Istanbul 34200, Turkey. dr.acoskun44@hotmail.com
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: April 6, 2021
Revised: April 29, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: July 9, 2021
ARTICLE HIGHLIGHTS
Research background

Risk assessment in patients with a central venous catheter is necessary to prevent some unwanted consequences associated with invasive procedures.

Research motivation

The impact on the clinical, morbidity, and mortality of patients with central venous catheters in the emergency room population is worth investigating.

Research objectives

We aimed to determine whether there is a definite risk factor in short-term emergency room stay as the primary outcome of patients with central venous catheters and as a secondary outcome whether there is long-term morbidity and mortality at the time of hospitalization.

Research methods

In this study, 1042 patients who were admitted to the emergency department between 2005 and 2015 were analyzed, retrospectively. The patients in whom a central venous catheter was placed in the study were divided into three groups as jugular, subclavian, and femoral. Complications, diagnosis, and hospital stay after catheter insertion were evaluated.

Research results

The mean age of the patients was 60.99 ± 19.85 years; 423 (40.6%) of them were women. Hospitalization time was 11.89 ± 16.38 d. The mean age of the patients with jugular catheters was 60.74 ± 20.20 years, and 339 (40%) of them were women. The mean age of subclavian catheter patients was 59.66 ± 19.17 years, and 42 (27.3%) of them were women. In femoral catheters, the mean age was 63.67 ± 18.57 years, and 42 (42%) were women. There was a significant relationship between the inserted catheters with gender (P = 0.009) and hospitalization time (P = 0.040). , the biochemical values of the placed catheters were statistically significant with blood glucose, blood urea nitrogen, creatinine, and serum potassium. A significant association was observed in the analysis of patients according to complications (P = 0.001) and outcome stage (P = 0.001). While 174 (16.7%) of all patients were treated on an outpatient basis, 783 (75.1%) of them were found to be cured, and 85 (8.2%) died. In receiver operating characteristic curve analysis of hospitalization time and mortality, the area under curve was 0.575, the 95% confidence interval was 0.496-0.653, the sensitivity was 71%, and the specificity was 89% (P = 0.040).

Research conclusions

The jugular vein is safer and more comfortable for patient compliance between central venous catheters. Femoral vein catheters are at higher risk for infection. Changing central catheters frequently does not reduce the risk of infection and complications.

Research perspectives

Subclavian catheters have a high risk of hemopneumothorax in cachectic patients. Jugular catheters are safe. However, it is not preferred due to the discomfort of the patients and the limited neck movements. It is difficult to attach a jugular catheter to short and obese patients. Also, artery puncture is common. Femoral catheters are the group with the highest infection rate.