Central venous catheters are associated with thrombosis among adult inpatients undergoing therapeutic plasma exchange

• Published in: Journal of clinical apheresis 2022-08, Vol.37 (4), p.340-347
• Main Authors: Soares Ferreira Júnior, Alexandre, Boyle, Stephen H., Kuchibhatla, Maragatha, Onwuemene, Oluwatoyosi A.
• Format: Article
• Language: English
• Subjects: Apheresis; Catheters; central venous catheter; Health services utilization; healthcare utilization project; national inpatient sample; Plasma; Plasmapheresis; Thrombosis; Venous access
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.21975

Background For inpatients undergoing therapeutic plasma exchange (TPE) in the United States, the primary mode of venous access is the central venous catheter (CVC). To evaluate the impact of CVC on thrombosis outcomes of patients undergoing TPE, we analyzed the National Inpatient Sample (NIS) database. Study Design and Methods In a cross‐sectional analysis of the NIS, we identified hospital discharges of adult patients treated with TPE. Cases were classified into two groups based on CVC status. The primary outcome was thrombosis. Secondary outcomes were major bleeding, packed red blood cell (PRBC) transfusion, in‐hospital mortality, hospital length of stay (LOS), and charges. Results Among 9863 TPE‐treated discharges, CVC was used in 5988 (60%). These numbers correspond to weighted national estimates of 49 315 and 29 940, respectively. There was a positive and significant association between CVC and thrombosis (OR = 1.23, 95% 1.04‐1.46, P = 0.0174), PRBC transfusion (OR = 1.15, 95% 1.03‐1.29, P = 0.0121), in‐hospital mortality (OR = 1.36, 95% 1.10‐1.68, P = 0.0043), hospital LOS (15.63 vs 12.45 days, P