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• W2980486572 abstract "SESSION TITLE: Pleural Infections: Risk Factors and Management Options SESSION TYPE: Original Investigations PRESENTED ON: 10/22/2019 10:45 AM - 11:45 AM PURPOSE: The practice of using indwelling pleural catheters (IPC) for the management of recurrent pleural effusions has drastically increased in recent years. Among the complications, infections such as cellulitis and pleural infection are of primary concern due to the susceptibility of candidates and their high morbidity and mortality. Infections rates vary from 1.7-12%. The purpose of this study is to identify risk factor for the development of IPC related infections. METHODS: A retrospective chart review was done of all IPC insertions from 2012-2018 at Beth Israel Deaconess Medical Center. Baseline demographic and laboratory data were recorded as well as microbiologic data from infections. The primary outcome was the composite of cellulitis or pleural infections. Multivariable logistic regression analysis was done to identify independent risk factors. Statistically significant predictors in univariable analysis were selected for multivariable regression analysis. RESULTS: A total of 246 subjects were identified. Mean age was 69.6 years (±12.7), and 59.4% were female. 8% had bilateral IPC placement, and 42.3% had right-sided IPC. The most common diagnosis was malignant pleural effusion (MPE) 171 (69.5%), 34 (13.8%) Congestive Heart Failure (CHF), 3 (2%) Hepatic Hydrothorax. Median time to infection was 29 days (IQR, 17, 57). 11 (22.9%) subjects had cellulitis, 27 (56.3%) had pleural infections, and 10 (20.8%) had both cellulitis and pleural infections. Univariable regression analysis revealed that age, gender, length of stay, amount of fluid drained, home nursing care, number of drainage days per week, serum white blood cell count (WBC), pleural fluid WBC, pleural fluid glucose, and pleural fluid pH were not significant risk factors for the development of an IPC related infection. Multivariable logistic regression analysis revealed that chemotherapy OR 12.25 (95% CI 3.9 – 37.9), pleural fluid Neutrophils > 55% OR 8.7 (95% CI 3.9 – 19.1), and pleural fluid protein < 3 g/dl OR 3.3 (95% CI 1.4 – 7.7). CONCLUSIONS: When considering IPC insertion, the use of chemotherapy, pleural fluid protein, and Neutrophils should be taken into consideration when evaluating patient candidacy. Additionally, patients should be closely monitored during the first month after IPC insertion as over half of the infections occur during this period. CLINICAL IMPLICATIONS: We show clear evidence that both clinical and laboratory data prior to IPC insertion can be associated with IPC related infections. Patients with certain characteristics at the time of IPC drainage should be closely monitored in order to avoid IPC related infections. DISCLOSURES: Consultant relationship with Boston Scientific Please note: $1001 - $5000 Added 03/15/2019 by Alex Chee, source=Web Response, value=Consulting fee No relevant relationships by Van Holden, source=Web Response Consultant relationship with Boston Scientific Please note: $1001 - $5000 Added 03/16/2019 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with olympus Please note: $5001 - $20000 Added 03/16/2019 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with pinacle biologics Please note: $1001 - $5000 Added 03/16/2019 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with cook medical Please note: $1001 - $5000 Added 03/16/2019 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Mihir Parikh, source=Web Response No relevant relationships by Estefania Rivera, source=Web Response No relevant relationships by Carlos Sisniega, source=Web Response" @default.
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• W2980486572 date "2019-10-01" @default.
• W2980486572 modified "2023-09-25" @default.
• W2980486572 title "IDENTIFICATION OF RISK FACTORS ASSOCIATED WITH INDWELLING PLEURAL CATHETER RELATED INFECTIONS" @default.
• W2980486572 doi "https://doi.org/10.1016/j.chest.2019.08.817" @default.
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