3. Table of excluded studies ‐ Retrospective cohort studies of adult populations.
| Retrospective studies – adult populations | |||||||||
| Author |
Population (study period) |
Sample size (CVCs) | Outcome | Intervention | Analysis and results | Overall mortality | Results in favour of | STROBE | Comments |
| Patino 2012 | Adult candidaemia cases with a central venous catheter (2008 to 2010) |
1027 (1027) |
Mortality | Catheter removal within 7 days | Multi‐variate: HR 0.64, 95% CI 0.45 to 0.92, P value not provided |
N/A | Removal | Yes. | Propensity score model showed no significant association between catheter removal and improved survival (HR 0.77, 95% CI 0.50 to 1.20) |
| Takesue 2015 | Non‐neutropenic participants > 17 years old treated with antifungals for candidaemia. (2011 to 2012) |
608 (510) | 28‐Day survival | Catheter removal within 24 hours of diagnosis | Multi‐variate: OR 2.97, 95% CI 1.51 to 5.85, P value not provided |
0.27 | Removal | No. Design not clear from title or abstract. Demographics not described | Participants who did not receive antifungal treatment were excluded from analysis |
| Anaissie 1998 | Adults with malignant disease and candidaemia (1988 to 1992) |
476 (364) |
90‐Day mortality or non‐cure | Catheter retention for longer than 0, 2 or 4 days | Multi‐variate: full exchange of catheter: OR 2.0, 95% CI 1.4 to 2.9, P value = 0.061. Full exchange or exchange over guidewire: OR 2.2, 95% CI 1.6 to 3.2, P value = 0.02 |
0.52 | Not significant | Yes | Study provides detailed data on timing of removal and complete exchange vs exchange over guidewire |
| De Rosa 2015 | All participants hospitalized with candidaemia in internal medical wards (2004 to 2012) |
274 (195) | 28‐Day mortality | Catheter removal < 48 hours | Multi‐variate: OR 0.14, 95% CI 0.07 to 0,30, P value not provided |
0.39 | Removal | Yes. Limited discussion of bias and generalizability | Subgroup analysis of treated participants renders insignificant result: OR 0.129, 95% CI 0.061 to 0.274, P value not provided |
| Chen 2015 | Adult participants with candidaemia caused by C. parapsilosis sensu lato (2000 to 2012) |
323 (299) | 30‐Day survival | Catheter removal | Multi‐variate: OR 0.35, 95% CI 0.19 to 0.62, P value = 0.02 |
0.25 | Removal | No. Limitations not discussed | No participants were excluded from analysis Includes untreated participants Data retrieved from database |
| Gürcüoğlu 2010 | Adult participants with candidaemia (1996 to 2007) |
256 (230) |
30‐Day survival | Catheter removal within 0 to > 3 days (stratified) | Multi‐variate: OR 1.98 95% CI 1.22 to 3.20. P value = 0.006 |
0.5 | Removal | No. Limitations not discussed | No significant difference in day of removal (day 0 to day 3) |
| Tang 2014 | Admitted cancer participant with candidaemia (2009 to 2012) |
242 (182) |
In‐hospital mortality | Catheter removal | Uni‐variate: OR 0.68, 95% CI 0.38 to 1.21, P value = 0.19 |
0.51 | Not significant | Yes | |
| Bassetti 2015 | All participants with candidaemia (2009 to 2014) |
204 (172) |
30‐Day survival | Catheter removal within 24 hours | Multi‐variate: OR 3.77, 95% CI 1.3 to 11.76, P value = 0.014 |
0.47 | Removal | No. Limitations not discussed | No participants were excluded from analysis Only 168 participants received empirical treatment |
| Luzzati 2000 | Adults. Participants 12 years and older with candidaemia (1992 to 1997) |
189 (122) |
30‐Day mortality | Catheter removal | Multi‐variate: OR 0.62 95% CI 0.38 to 0.99, P value = 0.0477 |
0.45 | Not significant | No. Limitations not discussed | |
| Tang 2015 | Adults 65 years and older with candidaemia (2009 to 2012) |
175 (NA) |
Mortality | N/A | Uni‐variate: data not provided. Cited as not significant with P value = 0.059 |
0.50 | Not significant | No. Limitations not discussed | |
| Rodriguez 2007 | Adult candidaemia cases with a central venous catheter (2002 to 2004) |
172 (172) |
30‐Day mortality | Catheter removal within 2 days | Multi‐variate: risk ratio (RR): 1.0, 95% CI 0.8 to 1.3, P value not provided |
0.35 | Not significant | Yes | Participants were excluded from analysis if they died or were discharged before day 2 post candidaemia onset |
| Arnold 2010 | Hospitalized adults with candidaemia (2004 to 2006) |
167 (144) |
Hospital costs + Length of stay | Catheter removal within 24 hours | No analysis: data not provided. Cited as not significant |
0.26 | Not significant | Yes | Hospital costs equal between intervention and control groups (P value = 0.97) |
| Meltem 2015 | Adults with blood culture positive for Candida spp (2012 to 2014) |
140 (N/A) | Mortality | Catheter removal | N/A: mortality significantly reduced with catheter removal, P value = 0.046 |
0.53 | Removal | No. Statistical methods not described. Results insufficiently described | |
| Lai 2012 | Adult cancer participants with a Port‐A‐Cath and candidaemia (2003 to 2009) |
98 (98) |
30‐Day mortality | Catheter retention (median 7 days, range 2 to ‐19 days) | Multi‐variate: OR 9.05, 95% CI 3.08 to 26.62, P value < 0.001 |
0.57 | Removal | Yes | Participants were excluded from analysis if they died within 72 hours of onset of candidaemia. Participants who retained catheters had higher APACHE II score and more |
| Pasqualotto 2007 | Cases of candidaemia among adult participants (1995 to 2003) |
93 (93) |
30‐Day mortality | Catheter removal | Multi‐variate: data not provided. Cited as not significant |
0.62 | Not significant | No. Data not provided | No participants were excluded from analysis |
| Liu 2009 | Adults with malignant disease and single, non‐tunnelled CVC in place for 24 hours before candidaemia diagnosis (2004 to 2007) |
92 (92) |
30‐Day mortality | Catheter retention > 72 hours | Multi‐variate: HR 7.15, 95% CI 3.51 to 14.53, P value ≤ 0.001 |
0.60 | Removal | No. Results of uni‐variate analysis not provided | Participants were excluded from analysis if they died within 72 hours post candidaemia onset |
| Choi 2009 | Adults with candidaemia caused by C. glabrata/krusei vs C. albicans (1997 to 2006) |
81 (73) |
30‐Day mortality | Catheter maintenance | Multi‐variate: OR 9.14, 95% CI 1.69 to 49.53, P value = 0.01 |
0.54 | Removal | Yes | Participants who received no antifungal therapy were excluded from the analysis |
| Wang 2014 | Elderly participants (> 65 years) with candidaemia (2008 to 2010) |
63 (32) | 30‐Day mortality | Catheter removal | Multi‐variate: data not provided. Cited as not significant |
0.20 | Not significant | No. Data not provided | No participants were excluded from analysis Untreated participants in study |
| Tsai 2011 | Non‐neutropenic adults on total parenteral nutrition with candidaemia (2003 to 2005) |
59 (N/A) |
30‐Day mortality | Catheter retention | Multi‐variate: HR 9.01, 95% CI 3.160 to 25.70, P value < 0.001 |
0.54 | Removal | Yes | No participants were excluded from analysis Untreated participants in study |
| Charles 2003 | Adults with candidaemia in ICU (1990 to 2000) |
51 (49) |
Survival in ICU | Catheter removal within 24 hours | Uni‐variate: HR 2.14, 95% CI 0.87 to 5.24, P value = 0.09 |
0.61 | Not significant | Yes | |
| Inoue 1995 | Adults with catheter‐related candidaemia (1985 to 1991) |
30 (29) |
30‐Day mortality | Catheter removal | No analysis: mortality: removal: 6/19, retention: 9/10 |
0.52 | Not significant | No. Statistical analysis not performed | |
| Launay 1998 | Human immunodeficiency virus (HIV)‐infected adults with nosocomial candidaemia (1990 to 1995) |
13 (9) |
26‐Day mortality | Catheter removal | No analysis: mortality: removal: 1/7, retention: 2/2 |
0.38 | Not significant | No. Statistical analysis not performed | |
| APACHE: Acute Physiology and Chronic Health Evaluation; Candida spp: Candida species; CI: confidence interval; HIV: human immunodeficiency virus; HR: hazard ratio; ICU: intensive care unit; N/A: not available; OR: odds ratio; RR: risk ratio; STROBE: STrengthening the Reporting of OBservational studies in Epidemiology, strobe‐statement.org; vs: versus | |||||||||