K. M. Babbitt1, C. S. Gunasekera1, P. P. Parikh1, R. J. Markert1, M. B. Roelle1, M. C. McCarthy1 1Wright State University,Department Of Surgery,Dayton, OH, USA
Introduction:
The requirement for reliable central venous access for chemotherapy administration and repeated phlebotomy has led to an increase in the placement of central venous ports. We investigated the incidence of complications associated with port placement and other factors.
Methods:
A retrospective chart review of ports placed at a large community hospital over a five-year period was performed. Demographics, BMI, preoperative diagnosis, port site, site of venous access, duration of port period, stage/nature of port complication, and use of steroids, TPN, and chemotherapy were collected. Chi square, Mann-Whitney, and Fisher’s Exact tests were used to analyze the data (SPSS Statistics 23.0, IBM, Armonk, NY).
Results:
Of 289 total patients, 68.2% were female. The mean age, BMI, and port duration were 57.6±13.5 years, 30.1±8.5 kg/m², and 291.7±192.5 days, respectively. The port sites were well balanced between the right and left chest wall (51.9% and 48.1%). Right chest wall placement had double the complication incidence compared to left chest wall placement (16.7% vs. 7.9%, p=0.024). Complications most commonly associated with right chest wall placement were port pocket infection and catheter related blood stream infection. Complications did not differ by venous access (internal jugular vein=13.8% vs. subclavian=11.1%, p=0.49). Complication incidence was nearly three times greater in steroid users vs. non-users (22.2% vs. 8.3%, p=0.016). Complication incidence did not differ between patients given or not given chemotherapy (p=0.24) or TPN (p=0.69). Moreover, there was no relationship between age, gender, port site, and venous access site and those complications that occurred five or more times (port pocket infection, catheter-related infection, and malfunctioning ports).
Conclusion:
These results suggest that the placement of ports in the right chest wall and steroid use could lead to a higher incidence of complications. The application of these findings could decrease complications related to port placement and improve both patient care and outcomes.