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Objective <p>To quantify inter-center variation (ICV) in non-elective removal (NER) of central venous catheters (CVCs) in level 4 Neonatal Intensive Care Units (NICUs).</p> Study design <p>Using the Children’s Hospitals Neonatal Database (CHND), we identified CVCs in infants admitted 2017–2023. The primary outcome was CVC NER, and the primary exposure was CHND center. We quantified unadjusted and adjusted ICV in NER.</p> Result <p>We analyzed 71,865 patients and 135,671 CVCs. Median gestational age was 36 weeks and birth weight 2450 g. Over 50% infants (28,077) received &gt;1 CVC. Centers placed 196–7120 catheters with a median dwell time of 7 (IQR 4–14) days. The overall NER rate was 11.7%, with significant ICV (unadjusted ICV: 3–19%, <i>p</i> &lt; 0.001; adjusted center-level odds of NER: 0.26–2.03, <i>p</i> &lt; 0.001).</p> Conclusion <p>There is significant ICV in NER between level IV NICUs. Reducing modifiable NER may increase safety for patients with CVCs. Center-specific NER metrics may serve as clinical benchmarks.</p>

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Inter-center variation in non-elective removal of central catheters amongst level 4 NICUs

  • 期刊论文

  • 发表日期：

    2025年11月13日

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  • Lauren A. Beard,
  • Isabella Zaniletti,
  • Theresa R. Grover,
  • Michael A. Padula,
  • Karna Murthy

摘要

Objective

To quantify inter-center variation (ICV) in non-elective removal (NER) of central venous catheters (CVCs) in level 4 Neonatal Intensive Care Units (NICUs).

Study design

Using the Children’s Hospitals Neonatal Database (CHND), we identified CVCs in infants admitted 2017–2023. The primary outcome was CVC NER, and the primary exposure was CHND center. We quantified unadjusted and adjusted ICV in NER.

Result

We analyzed 71,865 patients and 135,671 CVCs. Median gestational age was 36 weeks and birth weight 2450 g. Over 50% infants (28,077) received >1 CVC. Centers placed 196–7120 catheters with a median dwell time of 7 (IQR 4–14) days. The overall NER rate was 11.7%, with significant ICV (unadjusted ICV: 3–19%, p < 0.001; adjusted center-level odds of NER: 0.26–2.03, p < 0.001).

Conclusion

There is significant ICV in NER between level IV NICUs. Reducing modifiable NER may increase safety for patients with CVCs. Center-specific NER metrics may serve as clinical benchmarks.