Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

Background: Home parenteral nutrition (HPN) has been shown to delay
deterioration in cancer patients with malnutrition. Its
risk-benefit ratio, however, is determined by the threat of central
venous catheter (CVC) complications. Only few prospective studies
on this subject exist, most of them based on small samples. The
objective of this study was to provide reliable estimates of
incidence rates of CVC complications in everyday HPN patient care
in Germany. Patients and Methods: Aiming for a large prospective
cohort study, we cooperated with a service provider caring for HPN
patients nationwide. Between July 1 and November 30, 2006, all
consecutive adult patients with more than 10 infusion days and no
previous history of HPN were recruited. Follow-up ended on January
31, 2007. Data were collected in a standardised way by the
provider's staff. To prevent underreporting, we used
computer-assisted telephone interviews with medical caregivers as a
provider-independent data source. Results: 481 patients met the
inclusion criteria, contributing a total of 31,337 catheter days.
52 patients experienced a total of 63 CVC complications, resulting
in an incidence rate of 2.01 CVC complications per 1,000 catheter
days including 1.02 CVC infections per 1,000 catheter days.
Conclusion: HPN administration can be safely performed with a
relatively low rate of CVC complications.