Abstract: 【Abstract】Objective To investigate the influencing factors relating to the accidental exit of tunneledcuffed catheter (TCC) in patients with maintenance hemodialysis (MHD). Methods Twenty-one MHD patients having the accidental exit of TCC during January 2016 to June 2021 treated in The First Affiliated Hospital of Fujian Medical University were retrospectively analyzed. Seventy- seven cases with TCC fixed in place were obtained by the system sampling method as the control group. Clinical data and laboratory results as the observation items were collected and compared between the two groups. Logistic regression was used
to analyze the relevant risk factors for accidental exit of TCC. Results There were 445 cases who met entry criteria in the period, and the rate of accidental exit was 4.72%. Multivariate regression analysis suggested that suture reaction at the TCC exit site (OR=9.289, 95% CI: 1.767～48.841, P=0.008), neutrophil to lymphocyte ratio (NLR) (OR=1.659, 95% CI: 1.053～2.613, P= 0.029), serum albumin (ALB) (OR=0.813, 95% CI:0.671～0.986, P=0.035) and serum phosphate (P) (OR=5.528, 95% CI: 1.486～20.560, P=0.011) were the independent risk factors for accidental exit of TCC. Conclusions Suture reaction at the TCC exit site, NLR, ALB and P are the independent risk factors relating to accidental exit of TCC in MHD patient. Therefore, effective control of local and systemic inflammation, improvement of nutritional status, and active control of blood phosphate may have clinical significance for preventing accidental exit of TCC.

Key words: Maintenance hemodialysis, Tunneled-cuffed catheter, Accidental exit, Influence factor