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SIR 2025
Venous Interventions
Scientific Session
Sung Bin Roh (he/him/his)
Medical Student
Larner College of Medicine, United States
Douglas Sutton, RN
Radiology Manager
UVM Medical Center, United States
Anant Bhave, MD
Associate Professor
University of Vermont Medical Center, United States
Geoffrey Scriver, M.D.
Physician-Scientist
University of Vermont Medical Center, United States
Joseph Shields, MD
Associate Professor
University of Vermont Medical Center, United States
Bruce McClellan, PA
Radiology Physician Assistant
University of Vermont Medical Center, United States
Christopher Morris, Division of Interventional Radiology, University of Vermont Medical Center
Professor of Radiology and Surgery at the Larner College of Medicine at the University of Vermont
Division of Interventional Radiology, University of Vermont Medical Center, United States
Bill Majdalany, MD, FSIR (he/him/his)
Associate Professor
University of Vermont Medical Center, United States
This study evaluates infection rates of inpatient versus outpatient chest port placement (CPP), before and after implementation of infection control measures (ICM).
Materials and Methods: As institutional quality assurance (QA), this was IRB exempt. A retrospective review of CPP at a single institution between January 2004 and June 2024 was conducted. CPP was divided by year and inpatient versus outpatient cohorts. Two time points of ICM were initiated. In 2008, this included standardized annual training for room turnover, in room tray preparation, proper surgical attire, hand hygiene, and sterile technique. Patient preprocedural skin disinfection was changed from iodine solutions to 2% chlorhexidine and ventilation in procedural suites was updated to at least 11 air exchanges per hour. In 2018, outpatient CPP added a povidone-iodine nares swab and a chlorhexidine chest scrub one hour prior to the pre-procedure patient preparation, which has not been performed for inpatient CPP. 30-day infection rates were collected and adjudicated during monthly QA conference. Criteria for a CPP infection specifically included fever ( >38˚C), white blood cell count >11,000 per mm3, purulent drainage from the surgical site, soft tissue erythema, positive blood culture, positive explant culture, or diagnostic criteria for sepsis. Statistical analysis was performed with a two-tailed t-test.
Results:
6,597 CPP were analyzed. Inpatients underwent 725 CPP (11%) and outpatient CPP was 5872 (89%). 60 CPP infections (0.91% overall rate) were identified with 16 from inpatient CPP (2.2%) and 44 from outpatient CPP (0.7%) (P< 0.001). Stratification of inpatient CPP by ICM at 2004-2008 and 2009-2024 revealed a 2.6% (3/115) and 2.1% (13/610) infection rate, respectively (P=0.53). Stratification of outpatient CPP by ICM at 2004-2008, 2009-2017, and 2018-2024 reveals 2.54% (13/511) vs. 0.67% (18/2689) (P < 0.001) and 0.48% (13/2672) (P =0.25). When comparing outpatient and inpatient CPP between similar time points 2004-2008, 2009-2017, and 2018-2024, the infection rates were 2.54% (13/511) for outpatient CPP vs 2.61% (3/115) for inpatient CPP (P =0.93), 0.67% (18/2689) for outpatient CPP vs 2.33% (6/258) for inpatient CPP (P < 0.001), and 0.49% (13/2672) for outpatient CPP vs 1.99% (7/352) for inpatient CPP (P < 0.001), respectively.
Conclusion:
CPP has a low infection rate, which was lower in outpatient CPP compared with inpatient CPP. ICM resulted in a statistically significant decrease in outpatient CPP compared with inpatient CPP. A multivariate analysis is planned.