Methods: We are conducting a prospective cohort study of patients discharged with CVCs to determine these outcomes. Patients discharged with tunneled CVCs, peripherally-inserted central catheters (PICCs), and Midline catheters from two academic medical centers, one tertiary care and one community-based hospital, were consented in this IRB-approved study. Participants were surveyed over the telephone every other week for the duration their CVCs were in place. Questions about clinical and functional outcomes, adverse events, exposures in the home environment, and overall experience were asked in a structured interview. Charts were abstracted through 30 days after therapy completion. To examine rates of complications, descriptive statistics were used.
Results: Of 73 patients discharged between March and April 2015 with CVCs, 36 (49.3%) consented for the study. Most had PICCs (N=29, 80.6%) and were receiving OPAT (N=30, 83.3%). Four had a major catheter-related complication (11.1%: 2 had catheter dislodgement; 2 had catheter-associated venous thrombosis). Of patients on OPAT, 13 of 30 (43.3%) had side effects from an antimicrobial agent, and therapy was changed in 4 (30.8%) of these patients. Eleven (30.6%) were readmitted within a month of hospital discharge. Many had exposures to potential environmental risks in the home: 22 (61.1%) had pets, 4 (11.1%) worked in a garden, and 19 (52.8%) had prepared raw meat for cooking while a CVC was in place.
Conclusion: Patients with CVCs in the home have high rates of hospital readmissions, and many on OPAT had adverse side effects from their antimicrobial agents, although most of these side effects were mild. Many patients may be exposed to environmental risks that could impact complications such as infections. These data are preliminary and further study is needed. When counseling patients getting discharged home with CVCs, we should identify and discuss ways to limit potential risk factors.
T. M. Perl, None
K. Pulice, None
M. Gavgani, None
D. Hirsch, None
D. Williams, None
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