Amaury Bailleul , Jean-Pierre Fulgencio , Sophie Vimont , Cécile Mordelet , Benoit Ray , Ludovic Lassel , Nathanaël Lapidus , Christophe Quesnel , Marc Garnier
{"title":"Risk factors and prognostic significance of infection of totally implantable vascular access port in solid tumor patients: A prospective cohort study","authors":"Amaury Bailleul , Jean-Pierre Fulgencio , Sophie Vimont , Cécile Mordelet , Benoit Ray , Ludovic Lassel , Nathanaël Lapidus , Christophe Quesnel , Marc Garnier","doi":"10.1016/j.idnow.2023.104766","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>Totally implantable venous access ports (TIVAP) are devices mainly used to deliver antineoplastic chemotherapies, of which the insertion may be complicated by TIVAP-related infection (TIVAP-RI). This study aims to provide data on the risk factors for TIVAP-RI and its influence on patient prognosis.</p></div><div><h3>Patients and methods</h3><p>Prospective observational study including adult patients with solid tumors, in whom a TIVAP was inserted to deliver antineoplastic chemotherapy between January 2018 and October 2019. Factors associated with TIVAP-RI and one-year mortality were determined using multiple logistic regressions.</p></div><div><h3>Results</h3><p>More than a thousand (1014) patients were included, among whom 48 (4.7%) presented with TIVAP-RI. Gram-positive cocci and Gram-negative bacilli represented 51% and 41% of the pathogens isolated, respectively. Young age (odds ratio [OR] 0.67; 95% Confidence Interval [0.53–0.83] per 10-year increase), WHO performance status ≥ 1 (OR 3.24 [1.52–7.79]), chemotherapy administration in the month before TIVAP placement (OR 2.26 [1.17–4.26]), and radiation therapy of the homolateral chest wall (OR 3.28 [1.51–6.67]) were independently associated with TIVAP-RI occurrence. During the year following TIVAP insertion, 287 (28%) patients died. TIVAP-RI was not associated with one-year mortality (OR 1.56 [0.75–3.19]).</p></div><div><h3>Conclusion</h3><p>TIVAP insertion in adult patients with solid tumors is associated with a low infection rate, which did not influence one-year mortality. In addition to young age and impaired health status, TIVAP insertion in the month following initiation of the antineoplastic chemotherapy and TIVAP insertion in an irradiated area are two newly reported preventable TIVAP-RI risk factors.</p></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious diseases now","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666991923001288","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
Totally implantable venous access ports (TIVAP) are devices mainly used to deliver antineoplastic chemotherapies, of which the insertion may be complicated by TIVAP-related infection (TIVAP-RI). This study aims to provide data on the risk factors for TIVAP-RI and its influence on patient prognosis.
Patients and methods
Prospective observational study including adult patients with solid tumors, in whom a TIVAP was inserted to deliver antineoplastic chemotherapy between January 2018 and October 2019. Factors associated with TIVAP-RI and one-year mortality were determined using multiple logistic regressions.
Results
More than a thousand (1014) patients were included, among whom 48 (4.7%) presented with TIVAP-RI. Gram-positive cocci and Gram-negative bacilli represented 51% and 41% of the pathogens isolated, respectively. Young age (odds ratio [OR] 0.67; 95% Confidence Interval [0.53–0.83] per 10-year increase), WHO performance status ≥ 1 (OR 3.24 [1.52–7.79]), chemotherapy administration in the month before TIVAP placement (OR 2.26 [1.17–4.26]), and radiation therapy of the homolateral chest wall (OR 3.28 [1.51–6.67]) were independently associated with TIVAP-RI occurrence. During the year following TIVAP insertion, 287 (28%) patients died. TIVAP-RI was not associated with one-year mortality (OR 1.56 [0.75–3.19]).
Conclusion
TIVAP insertion in adult patients with solid tumors is associated with a low infection rate, which did not influence one-year mortality. In addition to young age and impaired health status, TIVAP insertion in the month following initiation of the antineoplastic chemotherapy and TIVAP insertion in an irradiated area are two newly reported preventable TIVAP-RI risk factors.