Effectiveness of single-dose preprocedural antibiotics prior to port placement: A single-institution retrospective review

Abstract

a total of 1,033 chest ports were placed in 995 patients with cancer (Male/Female: 494/501, median age: 59 years). Medical records and imaging studies were reviewed to identify port complications requiring removal or treatment. The complications were classified as infection (local or systemic), mechanical failure (such as catheter malposition), thrombosis, and port site skin issue. Medical records and imaging studies were reviewed to record patients' demographics (age, gender, body mass index, diabetes, HIV, cancer type, presence of recurrence, prior port), laboratory data at placement (CBC, albumin, INR), medications (steroids, anticoagulants/platelets, bevacizumab), and port characteristics (lumen count, laterality, in/out patient placement). Risk factors for complications were elucidated using univariate and multivariate logistic regressions. Results: A total of 311,434 catheter-days (median per patient: 244 catheter days) were observed. A total of 133 patients (13.4%, 0.043/100 days) had a complication including 74 infections (7.4%, 0.024/100 days), 18 mechanical failure (1.8%, 0.006/100 days), 25 thromboses (2.5%, 0.008/100 days), and 23 skin issues (2.3%, 0.007/100 days). Leukocytosis (WBC411,000/mL; OR 1.88 95% CI 1.19-2.98, p ¼ .007), thrombocytopenia (plateletso150,000/mL; OR 1.77 95% CI 1.10-2.87, p ¼ .02), history for prior port (OR 2.94 95% CI 1.37-6.34, p ¼ .006), and patients under the age of 60 (OR 1.53 95% CI 1.03-2.26, p ¼ .03) all had a significantly increased risk for complications in multivariate logistic regression. Other variables were not statistically significant for port-related complications in multivariate analysis. Conclusions: Patients with a history of prior port appear to have almost 3 times higher chance of complications compared to those without this history. Alternative vascular access methods should be explored in this patient population, especially when leukocytosis and/or thrombocytopenia are present.