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Line Sepsis in Home Parenteral Nutrition Patients: Are There Socioeconomic Risk Factors? A Canadian Study

Albert Chang, MSc^*, Robert Enns, MD, Olivia Saqui, RN^*, Nazira Chatur, MD, Scott Whittaker, MD and Johane P. Allard, MD^*

From the ^* University of Toronto, Ontario, Canada, and Division of Gastroenterology, Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada; Division of Gastroenterology, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Gastroenterology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada

Correspondence: Johane P. Allard, MD, 585 University Avenue, Room 9N-973, Toronto, Ontario, M5G 2C5 Canada. Electronic mail may be sent to johane.allard{at}uhn.on.ca.

Background: Line sepsis complicates home parenteral nutrition (HPN). This study examined nonmedical risk factors that may contribute to line sepsis and compared 2 HPN programs with different administrative structures (Ontario and British Columbia [BC]) in terms of line sepsis and patient satisfaction. Methods: A survey was developed to evaluate possible correlation between line sepsis and (1) patients' perceptions of HPN care, (2) family support, (3) community support, and (4) socioeconomic status. Data were analyzed by categorizing into high- and low-risk groups using a cutoff point. A second method analyzed the incidences of line sepsis as a continuous variable. Results: Sixty-eight patients responded to the survey: 33 from Ontario (62%), 35 from BC (44%). Community agency, socioeconomic and educational status were not significant in determining line sepsis. Patients who had (1) medication or blood work done through the catheter, (2) a higher number of dependents, or (3) had a trained family member involved in HPN were in the high-risk category for line sepsis, in addition to patients who were part-time students or receiving social assistance. When comparing the provinces, there was no difference in line sepsis. However, significant differences between the provinces include (1) BC patients rate their level of care lower; (2) Ontario patients rely more on family members for HPN; and (3) Ontario patients have more community support. Conclusions: Line sepsis may be increased by some nonmedical risk factors. However, when comparing the 2 programs, rates of line sepsis were not influenced by different administrative structures.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 6, 408-412 (2005)
DOI: 10.1177/0148607105029006408


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