Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Number 291, Zhongzheng Road, Zhonghe District, Taipei City, 235, Taiwan.
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Langenbecks Arch Surg. 2022 Feb;407(1):343-351. doi: 10.1007/s00423-021-02328-0. Epub 2021 Sep 22.
Totally implantable venous access ports (TIVAP) have been widely used in cancer patients for many years. The early infection (within 30 days after TIVAP implantation) rate of TIVAP accounts for about one-third of all TIVAP infections, and early infection often causes port removal and affects subsequent cancer treatment. This study investigated the incidence and risk factors for early and late infection after TIVAP implantation.
From January 2013 to December 2018, all adult cancer patients who received TIVAP implantation in Taipei Medical University Shuang-Ho Hospital were reviewed. We evaluated the incidence of TIVAP-related infection, patient characteristics, and bacteriologic data. Univariable analysis and multiple logistic regression analysis were used to evaluate the risk factors of TIVAP-related infection.
A total of 3001 TIVAPs were implanted in 2897 patients, and the median follow-up time was 424 days (range: 1-2492 days), achieving a combined total of 1,648,731 catheter days. Thirty-one patients (1.0%) had early infection and 167 (5.6%) patients had late infection. In multivariate analysis, TIVAP combined with other surgeries (p = 0.03) and inpatient setting (p < 0.001) was the risk factor of early infection, and TIVAP combined with other surgeries (p = 0.007), hematological cancer (p = 0.03), and inpatient setting (p < 0.001) was the risk factor of late infection.
Inpatient TIVAP implantation and TIVAP implantation combined with other surgeries are associated with high rates of TIVAP-related early and late infections.
完全植入式静脉通路端口（TIVAP）已广泛应用于癌症患者多年。TIVAP 的早期感染（植入后 30 天内）发生率约占所有 TIVAP 感染的三分之一，早期感染常导致端口移除并影响后续癌症治疗。本研究旨在探讨 TIVAP 植入后早期和晚期感染的发生率和危险因素。
本研究回顾性分析了 2013 年 1 月至 2018 年 12 月期间在台北医学大学双和医院接受 TIVAP 植入的所有成年癌症患者。我们评估了 TIVAP 相关感染的发生率、患者特征和细菌学数据。采用单变量分析和多因素逻辑回归分析评估 TIVAP 相关感染的危险因素。
共植入 3001 个 TIVAP，2897 例患者，中位随访时间为 424 天（范围：1-2492 天），总导管天数为 1648731 天。31 例（1.0%）患者发生早期感染，167 例（5.6%）患者发生晚期感染。多因素分析显示，TIVAP 联合其他手术（p=0.03）和住院治疗（p<0.001）是早期感染的危险因素，TIVAP 联合其他手术（p=0.007）、血液系统恶性肿瘤（p=0.03）和住院治疗（p<0.001）是晚期感染的危险因素。
住院 TIVAP 植入和 TIVAP 植入联合其他手术与 TIVAP 相关早期和晚期感染发生率较高有关。
