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<p><b>Purpose</b></p><p>In patients with hematological malignancies and central venous catheters (CVC) men have a higher risk for CVC related bloodstream infections (CRBSI) than women. Hence, preventive strategies such as earlier CVC removal may reduce the overall CRBSI (oCRBSI) rate.</p><p><b>Methods</b></p><p>A randomized simulation using data from a CVC registry was performed. Data were derived from unselected patients with hematological or oncological diseases and a CVC. Patients were randomized to an experimental (EXP-G) or control group (CON-G). For the men in the EXP-G, one-day increments of an earlier CVC removal were simulated based on actual data and compared to men in the CON-G without simulation. The primary endpoint was oCRBSI rate.</p><p><b>Results</b></p><p>Underlying diseases were mainly hematological malignancies (87.3%). In the male patients with a median CVC in situ time of 13 days, the oCRBSI rate was 7.3% (103/1408), with 7.3% (53/729) in the EXP-G and 7.4% (50/679) in the CON-G. In the EXP-G, simulated shortening of CVC time by 1&#xa0;day in men resulted in an oCRBSI rate of 5.2% compared with 7.4% in the CON-G (<i>p</i> = 0.12). Shortening CVC time by 2 days led to an oCRBSI rate of 4% (<i>p</i> = 0.008); the corresponding median CVC time was 11 days. A 3-day shortening further to 10 days reduced the oCRBSI rate to 2.7% (<i>p</i> &lt; 0.001). Women from the same registry showed a 3.3% (30/920) oCRBSI rate after 12 days.</p><p><b>Conclusion</b></p><p>In conclusion, shortening the CVC dwell time in men by 2 or 3 days, corresponding to a CVC duration of 10–11 days, reduces the CRBSI rate in men and mitigates the higher risk, compared to women.</p><p>Clinical Trial Registration: SECRECY (Study to Evaluate Central Venous Catheter-related Infections in Hematology and Oncology) was registered within the German Clinical Trial Register (DRKS; no. DRKS00006551) on 29 September 2014.</p>

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Shortening of central venous catheter time in men with hematological and oncological diseases for prevention of central venous catheter-related bloodstream infections: a target-trial-emulation study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月10日

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  • Oliver Kriege,
  • Boris Böll,
  • Nicole Brüder,
  • Nicola Giesen,
  • Julia Lanznaster,
  • Susanne Mertins,
  • Antrea Minti,
  • Jan-Hendrik Naendrup,
  • Martin Schmidt-Hieber,
  • Ruth Seggewiss-Bernhardt,
  • Philipp Weber,
  • Kai Wille,
  • Jens Panse,
  • Marcus Hentrich,
  • Enrico Schalk,
  • Sabine Einhell,
  • Eva Fiegle,
  • Pierre Kremer,
  • Timo Schmitt,
  • Sebastian Schulz,
  • Christoph Schüssler,
  • Daniela Tölle,
  • Benedikt W. Pelzer,
  • Judit Grans-Siebel

摘要

Purpose

In patients with hematological malignancies and central venous catheters (CVC) men have a higher risk for CVC related bloodstream infections (CRBSI) than women. Hence, preventive strategies such as earlier CVC removal may reduce the overall CRBSI (oCRBSI) rate.

Methods

A randomized simulation using data from a CVC registry was performed. Data were derived from unselected patients with hematological or oncological diseases and a CVC. Patients were randomized to an experimental (EXP-G) or control group (CON-G). For the men in the EXP-G, one-day increments of an earlier CVC removal were simulated based on actual data and compared to men in the CON-G without simulation. The primary endpoint was oCRBSI rate.

Results

Underlying diseases were mainly hematological malignancies (87.3%). In the male patients with a median CVC in situ time of 13 days, the oCRBSI rate was 7.3% (103/1408), with 7.3% (53/729) in the EXP-G and 7.4% (50/679) in the CON-G. In the EXP-G, simulated shortening of CVC time by 1 day in men resulted in an oCRBSI rate of 5.2% compared with 7.4% in the CON-G (p = 0.12). Shortening CVC time by 2 days led to an oCRBSI rate of 4% (p = 0.008); the corresponding median CVC time was 11 days. A 3-day shortening further to 10 days reduced the oCRBSI rate to 2.7% (p < 0.001). Women from the same registry showed a 3.3% (30/920) oCRBSI rate after 12 days.

Conclusion

In conclusion, shortening the CVC dwell time in men by 2 or 3 days, corresponding to a CVC duration of 10–11 days, reduces the CRBSI rate in men and mitigates the higher risk, compared to women.

Clinical Trial Registration: SECRECY (Study to Evaluate Central Venous Catheter-related Infections in Hematology and Oncology) was registered within the German Clinical Trial Register (DRKS; no. DRKS00006551) on 29 September 2014.