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Outpatient Placement of Subcutaneous Venous Access Ports Reduces the Rate of Infection and Dehiscence Compared with Inpatient Placement

2013; Elsevier BV; Volume: 24; Issue: 6 Linguagem: Inglês

10.1016/j.jvir.2013.02.012

1535-7732

Nirnimesh Pandey, Jesse Chittams, Scott O. Trerotola,

Acute Kidney Injury Research

To determine whether the inpatient versus outpatient status of patients at the time of port placement affects the infection rate.Through a quality assurance database, all patients undergoing port insertion by interventional radiology personnel at a single institution between 2001 and 2010 were identified (N = 2,112). From this cohort, 1,030 patients with a known reason for port removal were retrospectively analyzed. All ports were of the same design. Data were analyzed according to inpatient/outpatient status at insertion and indications for port placement, including solid or hematologic malignancy and access for total parenteral nutrition or pheresis. Effects of inpatient/outpatient status on the reason for, and total time until, catheter removal were determined. Infections were defined as culture-positive bacteremia or clinically suspected port pocket infection.No significant differences were seen in age (P = .32), sex (P = .4), or access site (P = .4) between groups. There was a significant difference in total infection-free catheter days between groups, with means of 241 days for inpatients and 305 for outpatients (P<.001). Inpatients had a significantly higher infection rate per 1,000 catheter-days versus outpatients (0.72 vs 0.5; P = .01). Similarly, there was a significant difference between inpatients and outpatients in time to port removal for infection or dehiscence, with the hazard of inpatients needing removal 45% greater than that of outpatients (P = .03). The increased hazard of inpatients needing port removal was significant even after accounting for placement indication (P = .02).Port placement in an outpatient setting results in longer infection-free survival for a wide variety of placement indications.