Risk factors for skin injuries in cancer patients with peripherally inserted central catheter: A prospective multicenter cohort study

Background: The risk factors for skin injuries remain poorly understood in cancer patients with peripherally inserted central catheters (PICC). We herein aimed at exploring the effect of clinical factors on the risk of PICC-related skin injuries. Methods: We included 1245 cancer patients with PICC f...

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Veröffentlicht in:The journal of vascular access 2024-07, Vol.25 (4), p.1261-1270
Hauptverfasser: Wang, Rong, Li, Yuan, Xiang, Ling, Chen, Ke-jian, Wang, Xu, Mao, Ling-ling, Wei, Wen-shi, Wang, Xi-feng, Chen, Ya-mei, Wang, Mei-ling, Liu, Ming-hong, Yang, Yi-qun
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container_issue 4
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container_title The journal of vascular access
container_volume 25
creator Wang, Rong
Li, Yuan
Xiang, Ling
Chen, Ke-jian
Wang, Xu
Mao, Ling-ling
Wei, Wen-shi
Wang, Xi-feng
Chen, Ya-mei
Wang, Mei-ling
Liu, Ming-hong
Yang, Yi-qun
description Background: The risk factors for skin injuries remain poorly understood in cancer patients with peripherally inserted central catheters (PICC). We herein aimed at exploring the effect of clinical factors on the risk of PICC-related skin injuries. Methods: We included 1245 cancer patients with PICC from 16 hospitals in Suzhou, China. The study outcome was in-hospital skin injuries, including contact dermatitis, skin (epidermal) stripping, tension injury, allergic dermatitis, skin tear, maceration, folliculitis, and pressure injury. Results: During hospitalization, 274 patients (22.0%) developed skin injuries after prolonged use of an indwelling catheter. Univariable logistic regression analysis identified several risk factors for PICC-related skin injuries; multivariable logistic regression analysis showed that the following factors independently and significantly (p 25 kg/m2 versus
doi_str_mv 10.1177/11297298231158670
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We herein aimed at exploring the effect of clinical factors on the risk of PICC-related skin injuries. Methods: We included 1245 cancer patients with PICC from 16 hospitals in Suzhou, China. The study outcome was in-hospital skin injuries, including contact dermatitis, skin (epidermal) stripping, tension injury, allergic dermatitis, skin tear, maceration, folliculitis, and pressure injury. Results: During hospitalization, 274 patients (22.0%) developed skin injuries after prolonged use of an indwelling catheter. Univariable logistic regression analysis identified several risk factors for PICC-related skin injuries; multivariable logistic regression analysis showed that the following factors independently and significantly (p &lt; 0.05) associated with the risk of PICC-related skin injuries: body mass index (BMI, &gt;25 kg/m2 versus &lt;18.5 kg/m2: odds ratio (OR), 1.79; 95% confidence interval (CI), 1.03–3.11), skin condition (humid vs normal: OR, 2.96; 95% CI, 1.62–5.43), skin indentation (OR, 4.67; 95% CI, 3.31–6.58), allergic history (OR, 2.11; 95% CI, 1.21–3.66), history of dermatitis (OR, 3.05; 95% CI, 1.00–9.28), history of eczema (OR, 3.36; 95% CI, 1.20–9.43), catheter insertion site (under elbow vs. upper arm: OR, 3.32; 95% CI, 1.12–9.90), and PICC maintenance interval (4–5 days vs ⩽3 days: OR, 0.06; 95% CI, 0.01–0.50; 5–7 days vs ⩽3 days: OR, 0.07; 95% CI, 0.02–0.31; 7–9 days vs ⩽3 days: OR, 0.10; 95% CI, 0.02–0.57). Conclusions: BMI, skin condition, skin indentation, allergic history, history of dermatitis, history of eczema, catheter insertion site, and PICC maintenance interval were independent risk factors for PICC-related skin injuries in cancer patients. This knowledge will guide future studies with formulating optimal treatment strategies for improving the skin health of cancer patients with PICC.</description><identifier>ISSN: 1129-7298</identifier><identifier>ISSN: 1724-6032</identifier><identifier>EISSN: 1724-6032</identifier><identifier>DOI: 10.1177/11297298231158670</identifier><identifier>PMID: 36895143</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Catheterization, Central Venous - adverse effects ; Catheterization, Central Venous - instrumentation ; Catheterization, Peripheral - adverse effects ; Catheters, Indwelling - adverse effects ; Central Venous Catheters - adverse effects ; China - epidemiology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms - epidemiology ; Prospective Studies ; Risk Assessment ; Risk Factors ; Skin - injuries ; Time Factors</subject><ispartof>The journal of vascular access, 2024-07, Vol.25 (4), p.1261-1270</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-bf803afa0b78432621c3335723a1992a364a0d1707e01b16039584ec07385313</citedby><cites>FETCH-LOGICAL-c340t-bf803afa0b78432621c3335723a1992a364a0d1707e01b16039584ec07385313</cites><orcidid>0000-0001-6052-4162</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/11297298231158670$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/11297298231158670$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36895143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Rong</creatorcontrib><creatorcontrib>Li, Yuan</creatorcontrib><creatorcontrib>Xiang, Ling</creatorcontrib><creatorcontrib>Chen, Ke-jian</creatorcontrib><creatorcontrib>Wang, Xu</creatorcontrib><creatorcontrib>Mao, Ling-ling</creatorcontrib><creatorcontrib>Wei, Wen-shi</creatorcontrib><creatorcontrib>Wang, Xi-feng</creatorcontrib><creatorcontrib>Chen, Ya-mei</creatorcontrib><creatorcontrib>Wang, Mei-ling</creatorcontrib><creatorcontrib>Liu, Ming-hong</creatorcontrib><creatorcontrib>Yang, Yi-qun</creatorcontrib><title>Risk factors for skin injuries in cancer patients with peripherally inserted central catheter: A prospective multicenter cohort study</title><title>The journal of vascular access</title><addtitle>J Vasc Access</addtitle><description>Background: The risk factors for skin injuries remain poorly understood in cancer patients with peripherally inserted central catheters (PICC). We herein aimed at exploring the effect of clinical factors on the risk of PICC-related skin injuries. Methods: We included 1245 cancer patients with PICC from 16 hospitals in Suzhou, China. The study outcome was in-hospital skin injuries, including contact dermatitis, skin (epidermal) stripping, tension injury, allergic dermatitis, skin tear, maceration, folliculitis, and pressure injury. Results: During hospitalization, 274 patients (22.0%) developed skin injuries after prolonged use of an indwelling catheter. Univariable logistic regression analysis identified several risk factors for PICC-related skin injuries; multivariable logistic regression analysis showed that the following factors independently and significantly (p &lt; 0.05) associated with the risk of PICC-related skin injuries: body mass index (BMI, &gt;25 kg/m2 versus &lt;18.5 kg/m2: odds ratio (OR), 1.79; 95% confidence interval (CI), 1.03–3.11), skin condition (humid vs normal: OR, 2.96; 95% CI, 1.62–5.43), skin indentation (OR, 4.67; 95% CI, 3.31–6.58), allergic history (OR, 2.11; 95% CI, 1.21–3.66), history of dermatitis (OR, 3.05; 95% CI, 1.00–9.28), history of eczema (OR, 3.36; 95% CI, 1.20–9.43), catheter insertion site (under elbow vs. upper arm: OR, 3.32; 95% CI, 1.12–9.90), and PICC maintenance interval (4–5 days vs ⩽3 days: OR, 0.06; 95% CI, 0.01–0.50; 5–7 days vs ⩽3 days: OR, 0.07; 95% CI, 0.02–0.31; 7–9 days vs ⩽3 days: OR, 0.10; 95% CI, 0.02–0.57). Conclusions: BMI, skin condition, skin indentation, allergic history, history of dermatitis, history of eczema, catheter insertion site, and PICC maintenance interval were independent risk factors for PICC-related skin injuries in cancer patients. This knowledge will guide future studies with formulating optimal treatment strategies for improving the skin health of cancer patients with PICC.</description><subject>Adult</subject><subject>Aged</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Catheterization, Central Venous - instrumentation</subject><subject>Catheterization, Peripheral - adverse effects</subject><subject>Catheters, Indwelling - adverse effects</subject><subject>Central Venous Catheters - adverse effects</subject><subject>China - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms - epidemiology</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Skin - injuries</subject><subject>Time Factors</subject><issn>1129-7298</issn><issn>1724-6032</issn><issn>1724-6032</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1OwzAQhC0EolB4AC7IRy4pXjuJE25VxZ9UCQn1HrnOhrhNk2A7oD4A742rFi5InHa0_ma0HkKugE0ApLwF4LnkecYFQJKlkh2RM5A8jlIm-HHQ4T3aASNy7tyKMZ4nEJ-SkUiznRJn5OvVuDWtlPaddbTqLHVr01LTrgZr0AVBtWo1Wtorb7D1jn4aX9MerelrtKpptgFyaD2WVAcgrILF1-jR3tEp7W3netTefCDdDI03Oyjk6a7urKfOD-X2gpxUqnF4eZhjsni4X8yeovnL4_NsOo-0iJmPllXGhKoUW8osFjzloIUQieRCQZ5zJdJYsRIkk8hgCaGFPMli1EyKLBEgxuRmHxtueh_Q-WJjnMamUS12gyu4zFJgsWQ8oLBHdTjfWayK3pqNstsCWLErv_hTfvBcH-KH5QbLX8dP2wGY7AGn3rBYdYNtw2__SfwGx_-Nog</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Wang, Rong</creator><creator>Li, Yuan</creator><creator>Xiang, Ling</creator><creator>Chen, Ke-jian</creator><creator>Wang, Xu</creator><creator>Mao, Ling-ling</creator><creator>Wei, Wen-shi</creator><creator>Wang, Xi-feng</creator><creator>Chen, Ya-mei</creator><creator>Wang, Mei-ling</creator><creator>Liu, Ming-hong</creator><creator>Yang, Yi-qun</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6052-4162</orcidid></search><sort><creationdate>20240701</creationdate><title>Risk factors for skin injuries in cancer patients with peripherally inserted central catheter: A prospective multicenter cohort study</title><author>Wang, Rong ; Li, Yuan ; Xiang, Ling ; Chen, Ke-jian ; Wang, Xu ; Mao, Ling-ling ; Wei, Wen-shi ; Wang, Xi-feng ; Chen, Ya-mei ; Wang, Mei-ling ; Liu, Ming-hong ; Yang, Yi-qun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-bf803afa0b78432621c3335723a1992a364a0d1707e01b16039584ec07385313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Catheterization, Central Venous - instrumentation</topic><topic>Catheterization, Peripheral - adverse effects</topic><topic>Catheters, Indwelling - adverse effects</topic><topic>Central Venous Catheters - adverse effects</topic><topic>China - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms - epidemiology</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Skin - injuries</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Rong</creatorcontrib><creatorcontrib>Li, Yuan</creatorcontrib><creatorcontrib>Xiang, Ling</creatorcontrib><creatorcontrib>Chen, Ke-jian</creatorcontrib><creatorcontrib>Wang, Xu</creatorcontrib><creatorcontrib>Mao, Ling-ling</creatorcontrib><creatorcontrib>Wei, Wen-shi</creatorcontrib><creatorcontrib>Wang, Xi-feng</creatorcontrib><creatorcontrib>Chen, Ya-mei</creatorcontrib><creatorcontrib>Wang, Mei-ling</creatorcontrib><creatorcontrib>Liu, Ming-hong</creatorcontrib><creatorcontrib>Yang, Yi-qun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of vascular access</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Rong</au><au>Li, Yuan</au><au>Xiang, Ling</au><au>Chen, Ke-jian</au><au>Wang, Xu</au><au>Mao, Ling-ling</au><au>Wei, Wen-shi</au><au>Wang, Xi-feng</au><au>Chen, Ya-mei</au><au>Wang, Mei-ling</au><au>Liu, Ming-hong</au><au>Yang, Yi-qun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for skin injuries in cancer patients with peripherally inserted central catheter: A prospective multicenter cohort study</atitle><jtitle>The journal of vascular access</jtitle><addtitle>J Vasc Access</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>25</volume><issue>4</issue><spage>1261</spage><epage>1270</epage><pages>1261-1270</pages><issn>1129-7298</issn><issn>1724-6032</issn><eissn>1724-6032</eissn><abstract>Background: The risk factors for skin injuries remain poorly understood in cancer patients with peripherally inserted central catheters (PICC). We herein aimed at exploring the effect of clinical factors on the risk of PICC-related skin injuries. Methods: We included 1245 cancer patients with PICC from 16 hospitals in Suzhou, China. The study outcome was in-hospital skin injuries, including contact dermatitis, skin (epidermal) stripping, tension injury, allergic dermatitis, skin tear, maceration, folliculitis, and pressure injury. Results: During hospitalization, 274 patients (22.0%) developed skin injuries after prolonged use of an indwelling catheter. Univariable logistic regression analysis identified several risk factors for PICC-related skin injuries; multivariable logistic regression analysis showed that the following factors independently and significantly (p &lt; 0.05) associated with the risk of PICC-related skin injuries: body mass index (BMI, &gt;25 kg/m2 versus &lt;18.5 kg/m2: odds ratio (OR), 1.79; 95% confidence interval (CI), 1.03–3.11), skin condition (humid vs normal: OR, 2.96; 95% CI, 1.62–5.43), skin indentation (OR, 4.67; 95% CI, 3.31–6.58), allergic history (OR, 2.11; 95% CI, 1.21–3.66), history of dermatitis (OR, 3.05; 95% CI, 1.00–9.28), history of eczema (OR, 3.36; 95% CI, 1.20–9.43), catheter insertion site (under elbow vs. upper arm: OR, 3.32; 95% CI, 1.12–9.90), and PICC maintenance interval (4–5 days vs ⩽3 days: OR, 0.06; 95% CI, 0.01–0.50; 5–7 days vs ⩽3 days: OR, 0.07; 95% CI, 0.02–0.31; 7–9 days vs ⩽3 days: OR, 0.10; 95% CI, 0.02–0.57). Conclusions: BMI, skin condition, skin indentation, allergic history, history of dermatitis, history of eczema, catheter insertion site, and PICC maintenance interval were independent risk factors for PICC-related skin injuries in cancer patients. This knowledge will guide future studies with formulating optimal treatment strategies for improving the skin health of cancer patients with PICC.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>36895143</pmid><doi>10.1177/11297298231158670</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-6052-4162</orcidid></addata></record>
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identifier ISSN: 1129-7298
ispartof The journal of vascular access, 2024-07, Vol.25 (4), p.1261-1270
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1724-6032
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source SAGE Complete A-Z List; MEDLINE
subjects Adult
Aged
Catheterization, Central Venous - adverse effects
Catheterization, Central Venous - instrumentation
Catheterization, Peripheral - adverse effects
Catheters, Indwelling - adverse effects
Central Venous Catheters - adverse effects
China - epidemiology
Female
Humans
Male
Middle Aged
Neoplasms - epidemiology
Prospective Studies
Risk Assessment
Risk Factors
Skin - injuries
Time Factors
title Risk factors for skin injuries in cancer patients with peripherally inserted central catheter: A prospective multicenter cohort study
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