Background: Peripherally Inserted Central Catheters (PICCs) and midline catheters are crucial for chemotherapy and supportive care in cancer patients. Their use requires ongoing monitoring to prevent late complications such as infections, dislodgements, and replacements. The COVID-19 pandemic challenged healthcare systems, potentially increasing these complications due to reduced outpatient services and limited specialized personnel. Objectives: This study compared the incidence of late complications associated with PICCs and midline catheters in cancer patients during and after the COVID-19 pandemic. Methods: A retrospective observational study was conducted at a Cancer Center in Italy from March 2020 to April 2024. Catheter-related complications were divided into two cohorts: during the pandemic (March 2020–March 2022) and post-pandemic (April 2022–April 2024). The primary outcome was the incidence of late complications requiring device removal, categorized as infections, dislodgements, and replacements. Statistical analyses included the Chi-squared test for categorical variables and the Kruskal–Wallis test for continuous variables. Results: Of 4104 PICC and midline catheter placements, 2291 removals were recorded, with 550 (24%) due to late complications—404 during the pandemic and 146 post-pandemic (p< 0.001). Suspected infections were the most frequent complication, significantly higher during the pandemic (p< 0.001). Dislodgements and replacements also decreased markedly post-pandemic. Limited outpatient services and disrupted healthcare workflows likely contributed to higher complication rates during the pandemic. Conclusions: The COVID-19 pandemic negatively impacted catheter management in cancer patients, increasing late complications. The post-pandemic decline highlights the importance of consistent care, infection prevention, remote monitoring, and stronger healthcare resilience to reduce risks in future crises.
背景：经外周静脉置入中心静脉导管（PICC）和中线导管对癌症患者的化疗及支持治疗至关重要。其使用过程需要持续监测，以预防感染、移位及更换等晚期并发症。COVID-19大流行对医疗系统造成冲击，门诊服务缩减及专业人员受限可能增加了此类并发症的发生风险。目的：本研究比较了COVID-19大流行期间及之后癌症患者PICC与中线导管相关晚期并发症的发生率。方法：在意大利某癌症中心开展了一项回顾性观察研究，时间跨度为2020年3月至2024年4月。将导管相关并发症分为两个队列：大流行期间（2020年3月–2022年3月）与大流行后（2022年4月–2024年4月）。主要结局指标为需要拔除导管的晚期并发症发生率，分为感染、移位及更换三类。统计分析采用卡方检验处理分类变量，Kruskal–Wallis检验处理连续变量。结果：在4104例PICC及中线导管置入中，共记录2291例拔管事件，其中550例（24%）因晚期并发症导致——大流行期间404例，大流行后146例（p<0.001）。疑似感染是最常见的并发症，且大流行期间发生率显著更高（p<0.001）。移位与更换事件在大流行后也显著减少。门诊服务受限及医疗工作流程中断可能是大流行期间并发症率升高的重要原因。结论：COVID-19大流行对癌症患者的导管管理产生了负面影响，导致晚期并发症增加。大流行后并发症率的下降凸显了持续规范护理、感染预防、远程监测以及提升医疗系统韧性的重要性，以降低未来危机中的风险。
肿瘤(癌症)患者之家