Incidence of catheter-related infection in cancer patients receiving parenteral nutrition: A retrospective cohort study of French administrative claims data

Data confirming parenteral nutrition (PN) as an independent risk factor for catheter-related infection (CRI) are scarce and not recent. This study aims to estimate the effect of PN on CRI in cancer patients after catheter placement. A retrospective cohort analysis of the French National Health Data System was conducted. A total of 5300 gastric, 5975 pancreatic, and 15,102 lung cancer patients with central venous catheter insertion between 2012 and 2016 were included. Potential confounders for CRI were evaluated using Poisson regression. Incidence rates (IRs) of CRI were calculated. Incidence rate ratio (IRR) was estimated to assess the effect of exposure to PN on infection occurrence in all patients and among patients receiving chemotherapy (CT). The independent risk factors found to be associated with CRI were age, sex, Charlson Comorbidity Index, PN, CT, metastasis, and history of infection. After adjustment, there was an increased risk of CRI in patients with versus without PN in gastric (IRR: 1.1165; 95% confidence interval [95% CI]: 1.0119-1.2319), pancreatic (IRR: 1.2071; 95% CI: 1.0985-1.3265), and lung cancer (IRR: 1.1850; 95% CI: 1.0832-1.2962). In patients who received PN, IRs of CRI were higher than in those who did not, for gastric (34.84% vs 29.69%, respectively; P = .0001), pancreatic (38.89% vs 28.58%, respectively; P < .0001), and lung (23.64% vs 22.13%, respectively; P = .0967) cancer cohorts. The results of this National administrative claims database analysis suggested that PN might be one of the independent risk factors for CRI. However, the risk was smaller than previously reported, regardless of whether the patient was receiving CT or not.