A retrospective statistical analysis of the late complications associated with central venous port placements

Okada, Shingo; Shiraishi, Akihiko; Yamashiro, Y; Inoue, Tatsuro; Tsuge, Daisuke; Aida, Mari; Kuwatsuru, Ryohei

doi:10.1007/s11604-014-0375-0

Cited by 16 publications

(11 citation statements)

References 10 publications

(11 reference statements)

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“…In a retrospective single-center analysis of 264 implanted port catheters, 50 (18.9%) had to be removed due to infection, suspected infection or catheter problems [29]. In an Italian study, a catheter-related complication rate of 7% was reported [30].…”

Section: Discussionmentioning

confidence: 99%

Cisplatin-Based Chemotherapy for Testicular Germ Cell Tumors: Complication Rates of Peripheral versus Central Venous Administration

Worst

Sautter²,

John³

et al. 2015

Urol Int

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Objective: Despite the low local toxicity of the used agents, Cisplatin-based chemotherapy (CBP) for patients with testicular germ cell tumors (TGCT) is mostly delivered via a central venous access (CVA). Since 2008, CBP is given peripherally in our hospital. Methods: Medical reports of TGCT patients who received CBP between September 1991 and August 2014 were evaluated. Complications regarding the way of administration (CVA vs. peripheral venous catheter [PVC]) were classified according to the Common Terminology Criteria of Adverse Events. The complication rates were compared using chi square test and propensity score matching. Results: During 288 cycles in 109 patients, 85 complications (29.5%) were observed with similar rates for overall (PVC 31.3%, CVA 29.9%; p = 0.820) and grade I complications (21.3%, 25.4%; p = 0.470). More grade II complications were observed in the PVC group (10.0 vs. 1.5%; p < 0.001). Grade III complications requiring invasive treatment were found only in the CVA group (3.0%; p = 0.120). Using propensity score matching, no differences in overall (p = 0.950), grade I (p = 0.540) and grades II/III (p = 0.590) complications were seen. Conclusion: The peripheral and central administration of CBP has similar overall complication rates. Despite more grade II complications, the peripheral administration of CBP is a safe alternative for TGCT patients. Additionally, no severe grade III complications occurred.

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Section: Discussionmentioning

confidence: 99%

Cisplatin-Based Chemotherapy for Testicular Germ Cell Tumors: Complication Rates of Peripheral versus Central Venous Administration

Worst

Sautter²,

John³

et al. 2015

Urol Int

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“…31–34 Despite this variability, which could be ascribed to various factors related, for example, to the type of population studied or to the study design, there is no doubt that TIVAD-related infection is the most frequent indication to port removal. 26,27,29,35–38 In a recent French study on a cohort of patients with solid tumors, port-related infections required TIVAD removal in 81% of the cases, while conservative treatment was feasible only in a minority of patients. 37 Moreover, in the same study, 48% of the TIVAD-related infections were associated with complications, including 25% of septic shock.…”

Section: Epidemiologymentioning

confidence: 99%

Infection of totally implantable venous access devices: A review of the literature

et al. 2018

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Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient's quality of life. Nonetheless, totally implantable venous access devices are not free from complications. Among those, infection is the most relevant, affecting patients' morbidity and mortality-both in the hospital or outpatient setting-and increasing healthcare costs. Knowledge of pathogenesis and risk factors of totally implantable venous access device-related infections is crucial to prevent this condition by adopting proper insertion bundles and maintenance bundles based on the best available evidence. Early diagnosis and prompt treatment of infection are of paramount importance. As a totally implantable venous access device-related infection occurs, device removal or a conservative approach should be chosen in treating this complication. For both prevention and therapy, antimicrobial lock is a major matter of controversy and a promising field for future clinical studies. This article reviews current evidences in terms of epidemiology, pathogenesis and risk factors, diagnosis, prevention, and treatment of totally implantable venous access device-related infections.

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“…Numerous studies investigating complications associated with ports and the associated risk factors have been performed, with reported overall complication rates ranging from 7.2% to 32.1%. [2][3][4] Such complications are often divided into procedural, early complications (<30 days) and late complications (⩾30 days). 5 complications include catheter malposition or migration, arterial rupture, pneumothorax, wound dehiscence, and infection, with complication rates of 0.7% to 4.6%.…”

Section: Introductionmentioning

confidence: 99%

“…6 Late complications, including infection, venous thromboembolism (VTE), extravasation, and mechanical failure, have higher reported incidence rates of 1.9% to 17.0%. 3,6,7 Of these, infection and VTE have the highest reported incidence rates, ranging from 2.3% to 22.0% and 0.1% to 18.0%, respectively. 7 The rate of complications necessitating device removal is reported to be 6% to 7%.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Complications Following Port Insertion in a Cancer Patient Population: A Retrospective Analysis

Skelton

Franke

Welniak

et al. 2019

Clin Med Insights Oncol

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Central venous access devices, specifically implantable ports, play an essential role in the care of oncology patients; however, complications are prevalent. This retrospective single-institutional review was performed to identify rates of complications from port placement and potential factors associated with these events. A retrospective analysis of 539 cancer patients who underwent port insertion between March 2016 and March 2017 at our institution was conducted. Data examining 18 potentially predictive factors were collected, and multivariate analysis was conducted using logistic regression and odds ratios (ORs) with standard errors to determine predictive factors. Out of 539 patients, 100 patients (19%) experienced 1 complication, and 12 patients (2%) experienced 2 or more complications. An overall lower rate of complications was seen in patients on therapeutic anticoagulation (OR: 0.17, P < .001) or on antiplatelet agents (OR: 0.47, P = .02). No patients on therapeutic anticoagulation developed venous thromboembolism (VTE; 0%). Right-sided port insertion was associated with decreased rates of infection (OR: 0.44, P = .04). Insertion as inpatient was associated with an increased risk for mechanical failure (OR: 4.60, P < .01). This analysis identified multiple predictive factors that can potentially put patients at a higher risk of experiencing complications following port insertion. Our data show lower rates of VTE for patients on anticoagulation or antiplatelet therapy. Further analysis is also necessary to determine why port insertion as an inpatient places patients at a higher risk of complications. This study highlights the risks associated with port placement and prompts the clinician to have an informed discussion with the patient weighing the risks and benefits.

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A retrospective statistical analysis of the late complications associated with central venous port placements

Abstract: Steroid administration and TPN were associated with increased rates of infection. In addition, patients receiving chemotherapy or whose CV ports are left in place for a long time should be carefully observed to decrease these complications.

Cited by 16 publications

References 10 publications

Cisplatin-Based Chemotherapy for Testicular Germ Cell Tumors: Complication Rates of Peripheral versus Central Venous Administration

Cisplatin-Based Chemotherapy for Testicular Germ Cell Tumors: Complication Rates of Peripheral versus Central Venous Administration

Infection of totally implantable venous access devices: A review of the literature

Investigation of Complications Following Port Insertion in a Cancer Patient Population: A Retrospective Analysis

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