Journal article
Nationwide practices in the use of central venous catheters for therapeutic plasma exchange in the inpatient setting
Journal of clinical apheresis, Vol.36(6), pp.790-796
08/11/2021
DOI: 10.1002/jca.21929
Abstract
INTRODUCTIONTherapeutic plasma exchange (TPE) is often impacted by difficulties in obtaining an adequate and safe vascular access. This study evaluated the rates, predictive factors, and clinical outcomes associated with central venous catheter (CVC) use during the inpatient TPE procedures. METHODSThe Nationwide Readmissions Database, 2016 to 2017 was used to identify hospitalizations with TPE with and without CVC insertion. RESULTSDuring the study period, there were 35 429 hospitalizations with TPE (pediatric 6.1%, mean ± standard deviation (SD) age 50.9 ± 20.0 years, female 52.7%). CVC insertion was documented in 24 414 (73.4%) adult and 1596 (73.5%) pediatric hospitalizations. In pediatric patients, age >15 years, higher disease severity, and private insurance were associated with higher odds of CVC insertion. In adults, female sex, obesity, concurrent hemodialysis, and higher disease severity were associated with CVC insertion. Adults with private insurance and both adult and pediatric hospitalizations at the teaching hospitals had lower odds of CVC placement. All patients with CVC insertion had longer length of hospital stay, and adults with CVC insertion also had higher hospital charges, higher in-hospital mortality, and lower likelihood of being discharged to home. CONCLUSIONCVC insertion is performed for the majority of inpatient TPE procedures and CVC use appears to correlate with worse clinical outcomes.
Details
- Title: Subtitle
- Nationwide practices in the use of central venous catheters for therapeutic plasma exchange in the inpatient setting
- Creators
- Saurav Chopra - University of Iowa Hospitals and ClinicsAayushi Garg - University of Iowa Hospitals and ClinicsAnnette J Schlueter - University of Iowa Hospitals and ClinicsJohn L Blau - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Journal of clinical apheresis, Vol.36(6), pp.790-796
- DOI
- 10.1002/jca.21929
- ISSN
- 0733-2459
- eISSN
- 1098-1101
- Language
- English
- Date published
- 08/11/2021
- Academic Unit
- Pathology
- Record Identifier
- 9984185276702771
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