Risk factors for infectious and noninfectious complications of totally implantable venous catheters in cancer patients

Antonio Eduardo Zerati; Tamires Rocha Figueredo; Richard Diego de Moraes; Amanda Monteiro da Cruz; Joaquim Mauricio da Motta-Leal Filho; Maristela Pinheiro Freire; Nelson Wolosker; Nelson de Luccia

doi:10.1016/j.jvsv.2015.10.008

Journal article

Risk factors for infectious and noninfectious complications of totally implantable venous catheters in cancer patients

Antonio Eduardo Zerati, Tamires Rocha Figueredo, Richard Diego de Moraes, Amanda Monteiro da Cruz, Joaquim Mauricio da Motta-Leal Filho, Maristela Pinheiro Freire, Nelson Wolosker and Nelson de Luccia

Journal of vascular surgery. Venous and lymphatic disorders (New York, NY), Vol.4(2), pp.200-205

04/01/2016

DOI: 10.1016/j.jvsv.2015.10.008

PMID: 26993868

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Abstract

The aim of this study was to investigate the risk factors for complications of totally implantable catheters in a referral cancer center. This was a retrospective study of prospectively collected data of all consecutive cancer patients undergoing port placement, with a primary outcome of interest of major complication and subanalysis of the types of complications. We studied 1255 nonvalved implanted port catheters inserted in 1230 patients, for a combined total of 469,882 catheter-days of use. Venous puncture was ultrasound (US)-guided in 1049 cases (84%). Inadvertent arterial puncture occurred in 14 cases (1.1%) and was more frequent in procedures not guided by US (P = .045). Among the outpatients, 90 (9%) developed infection, and 75 (29%) of the hospitalized patients (P < .001) developed infections. Infection was diagnosed in 131 catheters (13%) implanted through the internal jugular vein (IJV), 23 catheters (14%) implanted in the subclavian vein (SCV), 1 catheter (5%) implanted in the external jugular vein, and 10 catheters (31%) implanted in the femoral vein (P = .044). In the multivariate analysis, only the hospitalization regimen maintained statistical significance, with hospitalization presenting as a risk factor for infection (P < .001). Regarding the introduction site, ambulatory patients in whom the femoral vein was the site of access had more infections than the others (28.6% vs 9.4% of the IJV, 4.8% of the SCV, and 4.8% of the external jugular vein; P = .019), which did not occur among the hospitalized patients (33.3% vs 26.5% of IJV and 39.5% of the SCV; P = .218). Not using US is a risk factor for iatrogenic arterial puncture. Port implantation in hospitalized patients and the use of femoral access are risk factors for infection.

Adolescent

Adult

Aged

Aged, 80 and over

Catheter-Related Infections - epidemiology

Catheterization, Central Venous - adverse effects

Catheters, Indwelling - adverse effects

Female

Humans

Jugular Veins

Male

Middle Aged

Neoplasms

Patients

Retrospective Studies

Risk

Risk Factors

Subclavian Vein

Young Adult

Details

Title: Subtitle: Risk factors for infectious and noninfectious complications of totally implantable venous catheters in cancer patients
Creators: Antonio Eduardo Zerati - Instituto do Câncer do Estado de São Paulo
Tamires Rocha Figueredo - Universidade de São Paulo
Richard Diego de Moraes - Universidade de São Paulo
Amanda Monteiro da Cruz - Universidade de São Paulo
Joaquim Mauricio da Motta-Leal Filho - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Maristela Pinheiro Freire - Instituto do Câncer do Estado de São Paulo
Nelson Wolosker - Instituto do Câncer do Estado de São Paulo
Nelson de Luccia - Instituto do Câncer do Estado de São Paulo
Resource Type: Journal article
Publication Details: Journal of vascular surgery. Venous and lymphatic disorders (New York, NY), Vol.4(2), pp.200-205
DOI: 10.1016/j.jvsv.2015.10.008
PMID: 26993868
NLM abbreviation: J Vasc Surg Venous Lymphat Disord
ISSN: 2213-333X
eISSN: 2213-3348
Language: English
Date published: 04/01/2016
Academic Unit: Radiology
Record Identifier: 9985180935202771

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