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. 2009 Feb;58(2):154-60.
doi: 10.1016/j.jinf.2008.12.008. Epub 2009 Jan 22.

Candidemia in cancer patients: impact of early removal of non-tunneled central venous catheters on outcome

C Y Liu  1 , L J Huang, W S Wang, T L Chen, C C Yen, M H Yang, L T Hsiao, C Y Liu, P M Chen, T J Chiou
Affiliations

Candidemia in cancer patients: impact of early removal of non-tunneled central venous catheters on outcome

C Y Liu et al. J Infect. 2009 Feb.

Abstract

Objective: To explore the impact of retention of non-tunneled central venous catheters (CVCs) on survival in candidemic cancer patients, where CVCs are commonly used and essential. A second object was to determine whether early CVC removal would benefit a subset of cancer patients.

Methods: We retrospectively evaluated 92 cancer patients who had a single, non-tunneled CVC in place. Patients were grouped according to CVC retention or removal; the later group was subdivided into early (CVC removed <or=72h after candidemia onset) and late removal. A Cox regression model was used for determining risk factors of adverse outcome and Kaplan-Meier analyses for comparing in-hospital 3-30 day survival among subgroups.

Results: Baseline characteristics were comparable between CVC retention (n=20) or removal (n=72) groups. CVC retention was a significant risk factor of poor outcome, independent of other significant prognostic host factors (hazard ratio 7.15, 95% confidence interval 3.51-14.53, p<0.001). Patients of early CVC removal (n=40) had significant better survival than those of late removal (n=32) (p<0.001).

Conclusion: The results suggest that retention of CVCs has a negative impact on survival in candidemic cancer patients, and that early CVC removal should be considered in a subset of cancer patients with candidemia.

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