Risk Factors for Totally Implantable Central Venous Access Port-related Infection in Patients With Malignancy

Abstract

Background: We sought to identify the risk factors of totally implantable central venous access port (TICVAP)related infections in patients with malignant disease. Patients and Methods: Overall, 324 consecutive patients who received a TICVAP at our institution were retrospectively analysed. We further analysed cases of TICVAP-related complications. The risk factors for TICVAP-related infection were investigated using Cox regression hazard models. Results: With a median TICVAP duration of 268 days (range=1-1,859 days), TICVAP-related complications were observed in 36 cases and infectious complications in late phase were the most common, seen in 19 cases (9.26%). A multivariate analysis showed that patients with head and neck malignancy (p<0.001) and patients who received TICVAP insertion in the upper arm (p<0.001) were independently at a higher risk for TICVAPrelated infections. Conclusion: Patients with head and neck malignancy or TICVAP insertion in the upper arm have potentially increased risk for late-phase TICVAP-related infections.Malignant disease is a major public health problem worldwide, with the number of patients with malignancy increasing (1). Multimodality treatments, consisting of chemotherapy, radiotherapy, and surgery have been increasingly utilised in malignant diseases to improve prognosis in the recent decade. Chemotherapy is usually administered for local and distant disease control in patients whose disease has not responded to combined radiation and surgery (2). The use of a totally implanted central venous access port (TICVAP), which was initiated in the early 1980s, has been standard practice for patients with malignant disease to facilitate the safe delivery of chemotherapy, hydration, and parenteral nutrition (3,4). TICVAP offers several advantages over central venous catheters, including their semi-permanent nature and ease of use, especially in ambulatory patients (5,6). Although TICVAP-associated complications have generally been very rare, several studies have reported complications after TICVAP insertion, such as infection (5-26%), thrombosis (2-26%), catheter malposition, catheter fracture, and catheter migration (7, 8). Once TICVAP-related complications are suspected, special care, such as extraction of the TICVAP, wound management, antibiotic therapy, and anticoagulation therapy, is needed. TICVAP-related complications result in an increased rate of sepsis-related mortality, a delay of hospitalisation, and impairment of the patient's quality of life (9).To date, the risk factors for TICVAP-related complications in patients with malignancy have not been completely elucidated. Thus, in this study, we retrospectively investigated 1547

Risk Factors of Catheter-Related Infection in Unplanned Extubation of Totally Implantable Venous-Accessportsin Tumor Patients

“…; late complications refer to complications that occur after the first use of the implantable IVAP, which mainly include catheter-related infections, thrombosis, catheter occlusion, and cardiac arrhythmia. It mainly includes catheter-related infections, thrombosis, catheter occlusion, drug extravasation, catheter displacement or fracture, catheter entrapment syndrome, superior vena cava ulceration or perforation, and infusion seat overturning [ 10 , 11 ], and catheter-related infections are the most common among them. Studies [ 12 , 13 ] reported that 46.2% of patients who had their infusion port removed during use did so because of catheter-associated infections, a rate much higher than complications such as thrombosis or other dysfunctions.…”

Silver-Mixed Port Reduces Venous Access Port Related Infection Rate Compared to Non-Silver-mixed Port: A Single-center Retrospective Analysis

“…Previous investigations have suggested that TPN, age over 65 years, hematological disease, and cancer with an oropharyngeal and pulmonary origin are risk factors for TIVAP-related infection [ 7 , 11 , 18 – 20 ]. Additionally, immunosuppressive status, such as neutropenia and long-term steroid usage, has been reported as a factor associated with infection [ 20 – 24 ].…”

“…Once TIVAP-related infection was clinically suspected, TIVAP was removed and cultured following blood culture. TIVAP-related infections were classified and defined according to either of the following criteria [ 7 ]:…”

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study

“…To identify potential factors related to CLABSI, patients’ characteristics including vital signs, laboratory data, performance status (PS), and classification of tumors were collected. White blood cell (WBC), total protein (TP), albumin, and C-reactive protein (CRP) were included as predictors of CLBASI according to the previous study ( 25 ). Data were collected the nearest day before implantation, usually 1 day before the surgery.…”