Meta Analysis Of Risk Factors Of Catheterization Infection In Maintenance Hemodialysis Patients

Objective:This paper aims to systematically evaluate the risk factors of catheterization infection in maintenance hemodialysis patients by means of Meta analysis,so as to guide clinicians in hemodialysis work for uremia patients,improve the quality of life and reduce the mortality rate of patients.Methods:Through the retrieval of the most authoritative databases at home and abroad,such as Pub Med,The Cochrane Library,Embase,CNKI,Wanfang,and China Scientific and Technological Journals Full Terms Database,the relevant studies on the risk factors of catheterization infection of any maintenance hemodialysis patients from the establishment of each database to March 1,2020 were searched and collected.Data extraction and quality evaluation were carried out for the literature The data were then analyzed using Rev Man 5.3 software and funnel plots were generated to identify publication bias.This Meta analysis has been registered on PROSPERO with ID CRD42020192267.Results:A total of 23 studies,21 at home and 2 abroad,involved 5428 participants,including 3091 males and 2311 females,with an overall prevalence rate of 16.1%.The following are the results of meta-analysis:1.Gender: 14 case-control studies,OR=1.07,95%CI[0.88,1.30],P=0.47.Three cohort studies(RR=0.80,95%CI[0.51,1.25],P=0.33)showed no statistical significance;2.Age: There were 9 case-control studies.After meta-analysis,OR=0.41,95%CI[0.16,1.06],P=0.07.There were 2 cohort studies.Results of Meta analysis were RR=0.71,95%CI[0.29,1.87],P=0.52.The results were not statistically significant;3.Anemia: There were 3 case-control studies.Meta-analysis showed OR=2.89,95%CI[1.81,4.60],P < 0.0001.There was 1 cohort study,RR=4.34,95%CI[2.12,8.90],P < 0.0001.The results were statistically significant;4.Hypoproteinemia: There were 4 case-control studies,Meta-analysis results OR=2.32,95%CI[1.54,3.50],P < 0.0001,the results were statistically significant;5.Diabetes: 12 case-control studies,Meta-analysis showed OR=3.21,95%CI[2.61,3.95],P < 0.0001.There were 3 cohort studies.Meta-analysis showed RR=2.58,95%CI[1.64,4.03],P < 0.0001,and the results were statistically significant;6.Catheter indwalling time: 7 case-control studies,Meta analysis showed OR=0.26,95%CI[0.20,0.35],P < 0.00001;1 cohort study,RR=0.36,95%CI[0.18,0.70],P=0.003;the results were statistically significant;7.Method of catheterization: There were 13 case-control studies,and Meta-analysis showed OR=0.26,95%CI[0.20,0.35],P < 0.00001;there were 1 cohort study,RR=0.21,95%CI[0.11,0.43],P < 0.00001;the results were statistically significant;8.Number of puncture: There were 6 case-control studies.Metaanalysis showed OR=0.31,95%CI[0.14,0.70],P=0.004.There were 1cohort study,RR=0.29,95%CI[0.14,0.58],P=0.0005,and the results were statistically significant;9.Use of antibiotics: 1 case-control study,Meta-analysis showed OR=2.56,95%CI [1.04,6.33],P=0.04.1 cohort study,RR=0.25,95%CI[0.12,0.52],P=0.0002.The evidence of evidence-based medicine was not high because there were fewer literatures,but the results were still statistically significant;10.Skin infection: Meta-analysis of two case-control studies showed OR=3.89,95%CI[1.69,8.95],P=0.001,and the results were statistically significant;11.Nursing puncture proficiency: 1 case-control study(OR=0.25,95%CI[0.10,0.63],P=0.003),1 cohort study(RR=0.26,95%CI[0.12,0.56],P=0.0005),the results were statistically significant.Conclusion:1.After Meta analysis,it was concluded that anemia,hypoproteinemia,diabetes,long catheter indwetting time,femoral vein catheterization,excessive number of puncture times,Puncture proficiency in medical care and skin infection were more likely to cause catheter infection in patients with maintenance hemodialysis catheterization,and gender was not a risk factor for catheter infection.2.The effect of antibiotic application on catheterization infection in maintenance hemodialysis patients is still controversial,and further study is needed due to the lack of evidence-based literature.3.Old age may be a risk factor for catheterization infection in maintenance hemodialysis patients,but the included literature was biased and its reliability decreased,which needs to be further clarified.