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A Comparison of Hickman Line- and Port-a-Cath-associated Complications in Patients with Solid Tumours Undergoing Chemotherapy

2007; Elsevier BV; Volume: 19; Issue: 7 Linguagem: Inglês

10.1016/j.clon.2007.04.003

1433-2981

Flora Ng, Heleni Mastoroudes, E. Paul, N. Davies, Jonathan Tibballs, Daniel Hochhauser, Allan R. Mayer, Richard H. J. Beǵent, Travis E. Meyer,

Nonmelanoma Skin Cancer Studies

To compare the complication rates of Hickman lines and Port-a-Caths in patients undergoing infusional chemotherapy for solid tumours.A single institution retrospective analysis comparing complication rates for 30 Hickman lines and 33 Port-a-Caths inserted for chemotherapy in adults with solid tumours was carried out.Patients were well matched in terms of primary site and chemotherapy regimen. In both cases, over 85% were inserted radiologically under local anaesthetic. The total time in situ for Hickman lines and Port-a-Caths was 3539 days (median 83, range 6-585) and 5783 days (median 158, range 20-456), respectively. The complication rate for Hickman lines was 5.09/1000 catheter days, almost five times that for Port-a-Caths, with 1.04/1000 catheter days, a relative risk of 4.9 (confidence interval: 1.9-15.1, P=0.0003). Most (73%) complications occurred within 4 weeks of insertion. However, some arose much later: the range of time to complication was 1-304 days for Hickman lines and 1-132 days for Port-a-Caths. Infection was the most common complication, accounting for nine of 18 Hickman line complications and five of six Port-a-Cath complications, giving an overall infection rate of 2.54/1000 catheter days and 0.86/1000 catheter days, respectively. Additionally, Hickman lines had a 26% leakage rate or displacement rate, which did not occur at all in the Port-a-Cath group. Complications required the removal of 16 Hickman lines and five Port-a-Caths. The rate of removal was five times higher for Hickman lines (Hickman lines=4.52/1000 catheter days, Port-a-Caths=0.86/1000 catheter days, P=0.0027). Overall, the cost of Port-a-Caths was less than that of Hickman lines.In this study, Port-a-Caths were shown to be both safer and cheaper than Hickman lines for patients requiring infusional chemotherapy.