Coskun A, Hıncal SÖ, Eren SH. Emergency service results of central venous catheters: Single center, 1042 patients, 10-year experience. World J Crit Care Med 2021; 10(4): 120-131 [PMID: 34316447 DOI: 10.5492/wjccm.v10.i4.120]
Corresponding Author of This Article
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
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
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 Processing time: 130 Days and 1.1 Hours
Abstract
BACKGROUND
Central venous catheterization is currently an important procedure in critical care. Central catheterization has important advantages in many clinical situations. It can also lead to different complications such as infection, hemorrhage, and thrombosis. It is important to investigate critically ill patients undergoing catheterization.
AIM
To evaluate the characteristics, such as hospitalization, demographic characteristics, post-catheterization complications, and mortality relationships, of patients in whom a central venous catheter was placed in the emergency room.
METHODS
A total of 1042 patients over the age of 18 who presented to the emergency department between January 2005 and December 2015 were analyzed retrospectively. The patients were divided into three groups, jugular, subclavian, and femoral, according to the area where the catheter was inserted. Complications related to catheterization were determined as pneumothorax, guidewire problems, bleeding, catheter site infection, arterial intervention, and sepsis. Considering the treatment follow-up of the patients, three groups were formed as outpatient treatment, hospitalization, and death.
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. There was a significant correlation between the inserted catheters with gender (P = 0.009) and hospitalization time (P = 0.040). Also, blood glucose, blood urea nitrogen, creatinine, and serum potassium values among the biochemical values of the patients who were catheterized were significant. A significant association was observed in the analysis of patients with complications that develop according to the catheter region (P = 0.001) and the outcome stage (P = 0.001). In receiver operating characteristic curve analysis of hospitalization time and mortality 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).
CONCLUSION
Catheter location and length of stay are important risk factors for catheter-borne infections. Because the risk of infection was lower than other catheters, jugular catheters should be preferred at entry points, and preventive measures should be taken by monitoring patients closely to reduce hospitalization infections.
Core Tip: A total of 1042 patients were included in this retrospective study. All central venous catheters were inserted in the emergency room. This study included 10 years of experience in our emergency department. In receiver operating characteristic curve analysis of hospitalization time and mortality, sensitivity was 71%, and specificity was 89% (P = 0.040). Complications in the subclavian vein and femoral vein were observed more frequently in the long term. Jugular vein catheterization can be preferred primarily due to the difficulties in application and due to the low number of complications.
