Tung-Cheng Chang1,2, Min-Hsuan Yen3, Kee-Thai Kiu3. 1. Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Number 291, Zhongzheng Road, Zhonghe District, Taipei City, 235, Taiwan. rotrin810@yahoo.com.tw. 2. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. rotrin810@yahoo.com.tw. 3. Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Number 291, Zhongzheng Road, Zhonghe District, Taipei City, 235, Taiwan.
Abstract
BACKGROUND: Totally implantable venous access ports (TIVAP) have been widely used in cancer patients for many years. The early infection (within 30 days after TIVAP implantation) rate of TIVAP accounts for about one-third of all TIVAP infections, and early infection often causes port removal and affects subsequent cancer treatment. This study investigated the incidence and risk factors for early and late infection after TIVAP implantation. METHODS: From January 2013 to December 2018, all adult cancer patients who received TIVAP implantation in Taipei Medical University Shuang-Ho Hospital were reviewed. We evaluated the incidence of TIVAP-related infection, patient characteristics, and bacteriologic data. Univariable analysis and multiple logistic regression analysis were used to evaluate the risk factors of TIVAP-related infection. RESULTS: A total of 3001 TIVAPs were implanted in 2897 patients, and the median follow-up time was 424 days (range: 1-2492 days), achieving a combined total of 1,648,731 catheter days. Thirty-one patients (1.0%) had early infection and 167 (5.6%) patients had late infection. In multivariate analysis, TIVAP combined with other surgeries (p = 0.03) and inpatient setting (p < 0.001) was the risk factor of early infection, and TIVAP combined with other surgeries (p = 0.007), hematological cancer (p = 0.03), and inpatient setting (p < 0.001) was the risk factor of late infection. CONCLUSION: Inpatient TIVAP implantation and TIVAP implantation combined with other surgeries are associated with high rates of TIVAP-related early and late infections.
BACKGROUND: Totally implantable venous access ports (TIVAP) have been widely used in cancer patients for many years. The early infection (within 30 days after TIVAP implantation) rate of TIVAP accounts for about one-third of all TIVAP infections, and early infection often causes port removal and affects subsequent cancer treatment. This study investigated the incidence and risk factors for early and late infection after TIVAP implantation. METHODS: From January 2013 to December 2018, all adult cancer patients who received TIVAP implantation in Taipei Medical University Shuang-Ho Hospital were reviewed. We evaluated the incidence of TIVAP-related infection, patient characteristics, and bacteriologic data. Univariable analysis and multiple logistic regression analysis were used to evaluate the risk factors of TIVAP-related infection. RESULTS: A total of 3001 TIVAPs were implanted in 2897 patients, and the median follow-up time was 424 days (range: 1-2492 days), achieving a combined total of 1,648,731 catheter days. Thirty-one patients (1.0%) had early infection and 167 (5.6%) patients had late infection. In multivariate analysis, TIVAP combined with other surgeries (p = 0.03) and inpatient setting (p < 0.001) was the risk factor of early infection, and TIVAP combined with other surgeries (p = 0.007), hematological cancer (p = 0.03), and inpatient setting (p < 0.001) was the risk factor of late infection. CONCLUSION: Inpatient TIVAP implantation and TIVAP implantation combined with other surgeries are associated with high rates of TIVAP-related early and late infections.
Authors: Felix J Hüttner; Tom Bruckner; Matthes Hackbusch; Jürgen Weitz; Ulrich Bork; Peter Kotschenreuther; Oliver Heupel; Sabine Kümmel; Hans J Schlitt; Matthias Mattulat; László Pintér; Christoph M Seiler; Carsten N Gutt; Hubertus S Nottberg; Alexander Pohl; Firas Ghanem; Thomas Meyer; Andreas Imdahl; Jens Neudecker; Verena A Müller; Tobias Gehrig; Mario Reineke; Moritz von Frankenberg; Guido Schumacher; Roland Hennes; André L Mihaljevic; Inga Rossion; Christina Klose; Meinhard Kieser; Markus W Büchler; Markus K Diener; Phillip Knebel Journal: Ann Surg Date: 2020-12 Impact factor: 12.969