153 Central venous catheter associated bloodstream infections and thrombosis in patients treated for gastroschisis and intestinal atresia Chapter 6 Furthermore, information was extracted concerning: patients’ sex, prematurity (defined as < 37 week gestational age), if the patient was diagnosed with trisomy 21, age at surgery, if the patient received an enterostomy as part of treatment, if the patient had a major postoperative complication (defined as Clavien-Dindo grade III or higher) in the first 30 days following surgery (excluding re-operations of placement of new central venous catheter only) [10], duration of hospital stay, number of abdominal surgical procedures received, mortality and length of follow-up. The occurrence of a CLABSI was noted if an organism was cultured from the blood from a central venous catheter (one or two bottles) that was in place for at least two days without having a bacterial infection based on other aetiology. The occurrence of a central venous catheter associated thrombosis was noted only in case of clinical suspicion (e.g., unexplained thrombocytopenia or line occlusion) which was confirmed radiologically by ultrasound. Asymptomatic thrombosis was excluded. These complications (CLABSI and catheter associated thrombosis), as well as catheter removal due to the complication, were noted separately with a maximum of the first three consecutive central venous catheters placements in each patient. For the first placed central venous catheter the following was extracted: complications directly occurring following catheter placement (incision on other side of the neck necessary because of problems identifying jugular veins, postoperative catheter tip readjustment necessary due to improper location on the X-ray following placement or pneumothorax), time from first admission until insertion, if the catheter was inserted directly into a central vein (meaning in the internal or external jugular vein, subclavian vein or femoral vein) either initially or following failure of peripheral insertion) or if insertion was done via a peripheral vein (all other veins used), if the catheter was tunnelled, catheter dwell time (meaning duration between insertion and removal of the catheter), the organism cultured at CLABSI diagnosis (organisms were classified as common commensals using National Healthcare Safety Network (NHSN) list from the Centre for Disease Control and Prevention (CDC))[11] , if other mechanical complications occurred (occlusion, dislocation or leakage), if death due to a central venous catheter complication occurred and if no central venous catheter associated complication occurred. It was also noted if the patient received a new central venous catheter up to the third central venous catheter. Occurrence of a CLABSI or a thrombosis were also noted for these central venous catheters. Patients with missing information on date of catheter placement or removal or patients that were transferred to another hospital before catheter removal were excluded.
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