Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

• Published in: Cardiovascular and interventional radiology Vol. 38; no. 3; pp. 651 - 656
• Main Authors: Bos, Aaron, Ahmed, Osman, Jilani, Danial, Giger, Maryellen, Funaki, Brian S., Zangan, Steven M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2015; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Bacterial Infections - epidemiology; BIOMEDICAL RADIOGRAPHY; Cardiology; Catheterization, Central Venous - adverse effects; Catheters, Indwelling - microbiology; CHEST; Clinical Investigation; Comorbidity; Female; HAZARDS; HEAD; Head and Neck Neoplasms - epidemiology; Humans; Imaging; Kaplan-Meier Estimate; Male; MEDICAL RECORDS; Medicine; Medicine & Public Health; Middle Aged; NECK; NEOPLASMS; NITROGEN 13; Nuclear Medicine; PATIENTS; PHOSPHORUS 32; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; REVIEWS; Risk Factors; Sex Factors; Thorax - microbiology; Treatment Outcome; Ultrasound; Young Adult; Infection; Head and neck cancer; Tracheostomy; Chest port
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-014-0973-3

Purpose The aim of this study was to investigate dual-lumen chest port infection rates in patients with head and neck cancer (HNC) compared to those with other malignancies (non-HNC). Materials and Methods An IRB-approved retrospective study was performed on 1,094 consecutive chest ports placed over a 2-year period. Patients with poor follow-up ( n  = 53), no oncologic history ( n  = 13), or single-lumen ports ( n  = 183) were excluded yielding a study population of 845 patients. The electronic medical records were queried for demographic information, data regarding ports and infections, and imaging review. Results HNC patients experienced more infections (42 vs. 30), an increased infection rate per 1,000 catheter days (0.68 vs. 0.21), and more early infections within 30 days compared to non-HNC patients (10 vs. 6) ( p  < 0.001, p  < 0.001, p  = 0.02, respectively). An existing tracheostomy at the time of port placement was associated with infection in the HNC group ( p  = 0.02) but was not an independent risk factor for infection in the study population overall ( p  = 0.06). There was a significant difference in age, male gender, and right-sided ports between the HNC and non-HNC groups ( p  < 0.01, p  < 0.001, and p  = 0.01), although these were not found to be independent risk factors for infection ( p  = 0.32, p  = 0.76, p  = 0.16). Conclusion HNC patients are at increased risk for infection of dual-lumen chest ports placed via a jugular approach compared to patients with other malignancies. Tracheostomy is associated with infection in HNC patients but is not an independent risk factor for infection in the oncologic population as a whole.