Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-05-06T04:19:15.459Z Has data issue: false hasContentIssue false
  • English
  • Français

A comparative analysis of infection and complication rates between single- and double-lumen ports

Published online by Cambridge University Press:  26 January 2024

Konrad M. Kozlowski Open the ORCID record for Konrad M. Kozlowski [Opens in a new window] ,
Hamed Jalaeian ,
Levi M. Travis  and
Joseph F. Zikria
Konrad M. Kozlowski*
Affiliation:
Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
Hamed Jalaeian
Affiliation:
Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
Levi M. Travis
Affiliation:
Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
Joseph F. Zikria
Affiliation:
Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
*
Corresponding author: Konrad Kozlowski; Email: konradkozlowski30@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Port-a-caths are implanted intravascular chest ports that enable venous access. With more port placements performed by interventional radiologists, it is important to discern differences in infection and complication rates between double- and single-lumen ports.

Methods:

We retrospectively reviewed 1,385 port placements over 2 years at the University of Miami. Patients were grouped by single- or double-lumen ports. Data on duration of catheter stay, bloodstream infections, malfunctions, and other complications (fibrin sheath, thrombosis, catheter malposition) were collected. Multivariate Cox regression was performed to identify variables predicting port infection.

Results:

The mean patient age was 58.8 years; the mean BMI was 26.9 kg/m2; and 61.5% of these patients were female. Our search revealed 791 double-lumen ports (57.1%) and 594 single-lumen ports (42.9%). The median follow-up was 668 days (range, 2–1,297). Double-lumen ports were associated with significantly higher rates of bacteremia (2.78% vs 0.84%; P = .02), port malfunction (8.3% vs 2.0%; P < .001), fibrin sheath formation (2.2% vs 0.5%; P < .02), catheter tip malposition (1.0% vs 0; P = .01), and catheter-associated thrombosis (1.4% vs 0; P = .003). Multivariate Cox regression analysis, after adjusting for other variables, showed that double-lumen chest ports had 2.98 times (95% confidence interval, 1.12–7.94) the hazard rate of single-lumen ports for developing bloodstream infection (P = .029).

Conclusions:

Double-lumen chest ports are associated with increased risk for bloodstream infection, malfunction, fibrin sheath formation, catheter tip malposition, and catheter-associated thrombosis. Interventional radiologists may consider placing single-lumen ports if clinically feasible; however, future studies are needed to determine clinical significance. The study limitations included the retrospective study design and the potential loss of patient follow-up.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , First View , pp. 1 - 5
Check for updates
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Biffi, R, de Braud, F, Orsi, F, et al. Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 1998;9:767–773.CrossRefGoogle Scholar
Tippit, D, Siegel, E, Ochoa, D, et al. Upper-extremity deep vein thrombosis in patients with breast cancer with chest versus arm central venous port catheters. Breast Cancer (Auckl) 2018;12:1178223418771909.Google Scholar
Strum, S, McDermed, J, Korn, A, Joseph, C. Improved methods for venous access: the port-a-cath, a totally implanted catheter system. J Clin Oncol 1986;4:596–603.CrossRefGoogle ScholarPubMed
Pegues, D, Axelrod, P, McClarren, C, et al. Comparison of infections in Hickman and implanted port catheters in adult solid-tumor patients. J Surg Oncol 1992;49:156–162.Google Scholar
Groeger, JS, Lucas, AB, Thaler, HT, et al. Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 1993;119:1168–1174.Google Scholar
Fischer, L, Knebel, P, Schröder, S, et al. Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients. Ann Surg Oncol 2008;15:1124–1129.Google Scholar
Narducci, F, Jean-Laurent, M, Boulanger, L, et al. Totally implantable venous access port systems and risk factors for complications: a one-year prospective study in a cancer centre. Eur J Surg Oncol 2011;37:913–918.Google Scholar
Zerati, AE, Figueredo, TR, de Moraes, RD, et al. Risk factors for infectious and noninfectious complications of totally implantable venous catheters in cancer patients. J Vasc Surg Venous Lymphat Disord 2016;4:200–205.CrossRefGoogle ScholarPubMed
Lebeaux, D, Larroque, B, Gellen-Dautremer, J, et al. Clinical outcome after a totally implantable venous access port-related infection in cancer patients: a prospective study and review of the literature. Medicine (Baltimore) 2012;91:309–318.CrossRefGoogle ScholarPubMed
Penel, N, Neu, JC, Clisant, S, Hoppe, H, Devos, P, Yazdanpanah, Y. Risk factors for early catheter-related infections in cancer patients. Cancer 2007;110:1586–1592.Google Scholar
Raad, I, Hanna, H, Maki, D. Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis 2007;7:645–657.Google Scholar
Veenstra, DL, Saint, S, Sullivan, SD. Cost-effectiveness of antiseptic-impregnated central venous catheters for the prevention of catheter-related bloodstream infection. JAMA 1999;282:554–5560.Google Scholar
Ignatov, A, Hoffman, O, Smith, B, et al. An 11-year retrospective study of totally implanted central venous access ports: complications and patient satisfaction. Eur J Surg Oncol 2009;35:241–246.CrossRefGoogle ScholarPubMed
Tsai, YF, Ku, YH, Chen, SW, Huang, WT, Lu, CC, Tsao, CJ. Right- and left-subclavian vein port-a-cath systems: comparison of complications. Eur Surg Res 2012;49:66–72.Google Scholar
Lin, WY, Lin, CP, Hsu, CH, et al. Right or left? Side selection for a totally implantable vascular access device: a randomised observational study. Br J Cancer 2017;117:932–937.Google Scholar
Sok, M, Zavrl, M, Greif, B, et al. Objective assessment of WHO/ECOG performance status. Support Care Cancer 2019;27:3793–3798.Google Scholar
Dezfulian, C, Lavelle, J, Nallamothu, BK, Kaufman, SR, Saint, S. Rates of infection for single-lumen versus multilumen central venous catheters: a meta-analysis. Crit Care Med 2003;31:2385–2390.Google Scholar
Lafuente Cabrero, E, Terradas Robledo, R, et al. Risk factors of catheter-associated bloodstream infection: systematic review and meta-analysis. PLoS One 2023;18:e0282290.Google Scholar
O’Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011;52:e162–e193.Google Scholar