Banca de DEFESA: CARLA SANTOS DE LIMA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : CARLA SANTOS DE LIMA
DATE: 25/08/2022
TIME: 18:30
LOCAL: Virtual - online
TITLE:

Bacteremia and mortality among patients with short-term and tunneled catheters for hemodialysis

KEY WORDS:

Chronic Kidney Disease; Hemodialysis; Vascular access.

PAGES: 3551
BIG AREA: Ciências da Saúde
AREA: Medicina
SUBÁREA: Clínica Médica
SPECIALTY: Nefrologia
SUMMARY:

Introduction: Central venous catheters (CVCs) for hemodialysis (HD) can be short-term catheters (STC) or tunneled catheters (TC). Bacteremia and dysfunction are complications that can impact morbidity and mortality. We decided tocompare the rates of bacteremia and dysfunction between STC and TC and the survival of patient survival 90 days after catheter insertion. Methods: Retrospective cohort to evaluate CVCs inserted between January 2011 and December 2020 in a tertiary hospital. CVCs in patients with end-stage chronic kidney disease were included. Patients with acute kidney injury, CVC that lasted less than three HD sessions, and patients who died within one week after insertion were excluded. Bacteremia and dysfunction rates, bacteremia-free survival, and dysfunction-free survival were investigated. Multivariate analysis was performed using a Cox proportional hazards regression model for patient survival at 90 days. Results: A total of 670 catheters were analyzed in 287 patients, which were 422 STC (63%) and 248 TC (37%). The rates of confirmed bacteremia per 1,000 catheter-days were 1.19 for STC and 0.20 for TC (p < 0.0001). The rates of confirmed or suspected bacteremia were 2.27 and 0.37 per 1,000 catheter-days for STC and TC, respectively (p < 0.0001). The dysfunction rates were 3.96 and 0.86 for STC and TC, respectively (p < 0.0001). Patient survival at 90 days was higher in the TC group compared to the STC group (96.8% vs 89.1%; p < 0.0001). Age in years (HR 1.033: 95% CI 1.009-1.057), albumin in g/dl (HR 0.278: 95% CI 0.154-0.505) and use of STC (HR 2.807: 95% CI 1.048-7.521) were the variables that influenced mortality 90 days after insertion. Conclusion: We found lower rates of bacteremia and dysfunction for TC, in addition to demonstrating that the use of STC influences patient mortality.

BANKING MEMBERS:
Presidente - 2154281 - RODRIGO PEIXOTO CAMPOS
Interna - 2272670 - ALINE CAVALCANTI DE QUEIROZ
Interno - 1506475 - ALYSSON WAGNER FERNANDES DUARTE
Interno - 1791653 - FLAVIO TELES DE FARIAS FILHO
Externa ao Programa - 1664417 - DANIELLA BEZERRA DUARTE
Externa à Instituição - MARIA ELIETE PINHEIRO