Complication Rates of Peripherally Inserted Central Catheters in Oncologic Versus Non-Oncologic Patients.

OBJECTIVES: Peripherally inserted central catheters are commonly used in cancer patients and provide vascular access for the administration of chemotherapy, antibiotics, or parenteral nutrition. Besides many advantages, they represent a source of possible complications such as catheter related blood stream infection, catheter occlusion, or thrombosis. In this study, the catheter-related complication rate between oncologic and non-oncologic patients was compared. METHODS: This retrospective cohort-study included 411 patients who underwent their first catheter placement at the Vienna General Hospital-Medical University of Vienna from January 2013 to June 2018. Patient demographics and catheter-related parameters were collected and statistically analyzed using a competing risk model. RESULTS: Mean catheter dwell time was 27.75 days. The overall complication rate was 7.54% (2.72 per 1000 catheter days). Underlying malignant disease (hazard ratio: 0.351, 95% confidence interval [CI]: 0.133-0.929, P = .035) and chemotherapy administration (hazard ratio: 2.837, 95% CI: 1.088-7.394, P = .033) were significantly associated with the occurrence of any kind of complication. Catheter related blood stream infection was observed among 11 (2.68%) patients and again significantly associated with chemotherapy administration (hazard ratio: 4.545, 95% CI: 1.178-17.539; P = .028). Thrombosis was found in 7 (1.70%) patients and occlusion in 13 (3.16%) cases. CONCLUSIONS AND IMPLICATIONS FOR NURSING PRACTICE: Choice of venous access is an interdisciplinary decision with emphasis on patient participation. In oncologic patients, our data suggests that the benefits of peripherally inserted central catheters regarding costs, invasiveness, and accessibility might be outweighed by the higher rate of complications associated with the device. This becomes even more important in a community care setting, where standardized handling procedures and patient education play a pivotal role in device safety.

It's poverty - not the pandemic: the impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

BackgroundThe COVID-19 pandemic has affected psychological wellbeing in many aspects, but its influence on cancer patients it not yet clear, and studies show mixed results. AimsWe aimed to investigate the impact of the pandemic on psychological symptom burden against the socio-economic background of cancer patients using data from routine assessments before and during the pandemic. MethodsStandardised assessment instruments were applied in N = 1,329 patients to screen for symptoms of anxiety, depression, post-traumatic stress, and fatigue from 2018 to 2022. Two MANOVAs with separate ANOVAs and Bonferroni pairwise comparisons as post-hoc tests were computed. First, only time was included as predictor to examine the isolated impact of the pandemic. Second, income level and education level were included as further predictors to additionally test the predictive power of socioeconomic risk factors. All tests were two-sided. ResultsOnce indicators of socioeconomic status were included in the analysis, the seeming influence of the pandemic became negligible. Only income had a significant impact on all aspects of psychological symptom burden, with patients with low income being highly burdened (partial {eta}2 = .01, p = .023). The highest mean difference was found for depressive symptoms (MD = 0.13, CI = [0.07; 0.19], p < .001). The pandemic had no further influence on psychological distress. ConclusionsAlthough the pandemic is a major stressor in many respects, poverty is by far the most important risk factor for psychological symptom burden in cancer outpatients and outweighs the impact of the pandemic.