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首页> 外文期刊>Journal of bronchology & interventional pulmonology >Predictors of Indwelling Pleural Catheter Removal and Infection
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Predictors of Indwelling Pleural Catheter Removal and Infection

机译：留住胸膜导管去除和感染的预测因素

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Background: Indwelling pleural catheters (IPCs) offer ambulatory management of symptomatic persistent pleural effusions, but their widespread use is somewhat hampered by the risk of pleural infection and the inconvenience of carrying a catheter for a prolonged period of time. Factors associated with these 2 limitations were analyzed in this study. Methods: Retrospective review of consecutive patients who had undergone IPC placement over a 5 ?-year period. Time to IPC removal was analyzed with the Fine and Gray competing risks survival model, with competing risk being death. A binary logistic regression method was used to evaluate factors influencing IPC-related pleural infections. Results: A total of 336 IPCs were placed in 308 patients, mostly because of malignant effusions (83%). IPC removal secondary to pleurodesis was achieved in 170 (51%) procedures at a median time of 52 days. Higher rates of IPC removal were associated with an Eastern Cooperative Oncology Group (ECOG) grade of 0 to 2 [subhazard ratio (SHR)=2.22], an expandable lung (SHR=1.93), and development of a multiseptated pleural space (SHR=1.37). IPC-related pleural infections occurred in 8% of the cases, and were more often seen in hepatic hydrothoraces [odds ratio (OR)=4.75] and pleural fluids with a C-reactive protein <15?mg/L before the IPC insertion (OR=4.42). Conclusion: IPC removal is more likely to occur in patients with good performance status whose lungs fully expand after drainage. Hepatic hydrothorax is the most significant predictor of IPC-related infections.
机译：背景：留置胸膜导管（IPCS）提供症状持续胸腔积液的动态管理，但他们的广泛使用是胸腔感染风险以及携带长时间携带导管的不便，他们的广泛使用有点阻碍。本研究分析了与这2个限制相关的因素。方法：回顾性审查，在5？ - 年期间经历了IPC放置的连续患者。通过良好和灰色的竞争风险生存模型分析了IPC去除的时间，竞争风险是死亡。二元逻辑回归方法用于评估影响IPC相关胸膜感染的因素。结果：在308名患者中，总共336个IPC，主要是因为恶性的积液（83％）。在52天的中位时间，170（51％）程序中逐步去除尿素瘤的IPC去除。较高的IPC去除率与东方合作肿瘤学群（ECOG）等级为0至2 [子灰率比（SHR）= 2.22]，一种可扩张的肺（SHR = 1.93），以及多相动胸腔空间的开发（SHR = 1.37）。与IPC相关的胸膜感染发生在8％的病例中，并且在IPC插入之前，肝脏湿度液（或）= 4.75]和具有C-反应蛋白<15·MG / L的胸膜流体（或= 4.42）。结论：在良好的性能状态下，IPC去除更容易发生肺部排水后完全扩张的患者。肝氢嗜睡剂是IPC相关感染最重要的预测因子。

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