Zhang Shunqing, Kobayashi Katsuhiro, Faridnia Masoud, Skummer Philip, Zhang Dianbo, Karmel Mitchel I
Division of Interventional Radiology, Department of Radiology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210.
Division of Interventional Radiology, Department of Radiology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210.
J Vasc Interv Radiol. 2018 Aug;29(8):1148-1155. doi: 10.1016/j.jvir.2018.04.014. Epub 2018 Jun 28.
To identify clinical predictors of port infections in adult patients with hematologic malignancies.
A retrospective chart review identified 223 adult patients (age ≥ 18 y) with hematologic malignancies, including lymphoma (n = 163), leukemia (n = 49), and others (n = 11), who had a port placed from 2012 to 2015. Early (< 30 d after port placement) and overall port infections (bloodstream and site infections) were recorded. To elucidate clinical predictors for early and overall port infections, proportional subdistribution hazard regression (PSHREG) analyses were conducted with variables including patients' demographics, medications used, laboratory data, and port characteristics.
Total duration of follow-up was 83,722 catheter-days (median per patient, 274 catheter-days). Early and overall port infections were identified in 8 (3.6%) and 26 (11.7%) patients, respectively. Early and overall infection rates were 1.2 and 0.3 infections/1,000 catheter-days, respectively. Backward stepwise multivariate PSHREG analyses identified hypoalbuminemia (< 3.5 mg/dL) at the time of port placement (hazard ratio = 5.03; 95% confidence interval, 1.14-22.16; P = .03) and steroid use (> 30 d cumulatively during follow-up period) (hazard ratio = 3.41; 95% confidence interval, 1.55-7.47; P = .002) as independent risk factors for early and overall port infections, respectively.
In adult patients with hematologic malignancies, hypoalbuminemia at the time of port placement was a clinical predictor for early port infections, whereas steroid use was a clinical predictor for overall port infections.
确定成年血液系统恶性肿瘤患者端口感染的临床预测因素。
一项回顾性病历审查确定了223例成年（年龄≥18岁）血液系统恶性肿瘤患者，包括淋巴瘤（n = 163）、白血病（n = 49）和其他（n = 11），这些患者在2012年至2015年期间放置了端口。记录早期（端口放置后<30天）和总体端口感染（血流和部位感染）情况。为了阐明早期和总体端口感染的临床预测因素，进行了比例亚分布风险回归（PSHREG）分析，变量包括患者的人口统计学特征、使用的药物、实验室数据和端口特征。
随访总时长为83,722导管日（每位患者中位数为274导管日）。分别在8例（3.6%）和26例（11.7%）患者中发现早期和总体端口感染。早期和总体感染率分别为1.2和0.3例感染/1000导管日。向后逐步多变量PSHREG分析确定，端口放置时低白蛋白血症（<3.5mg/dL）（风险比=5.03；95%置信区间，1.14 - 22.16；P = 0.03）和使用类固醇（随访期间累积>30天）（风险比=3.41；95%置信区间，1.55 - 7.47；P = 0.002）分别是早期和总体端口感染的独立危险因素。
在成年血液系统恶性肿瘤患者中，端口放置时的低白蛋白血症是早期端口感染的临床预测因素，而使用类固醇是总体端口感染的临床预测因素。
