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SIR 2025

Venous Interventions

Scientific Session

Session: General IR 1

Are Patients With Hematological Malignancy at a Higher Risk for Chest Port Infection Compared to Patients With Solid Malignancy? -Propensity Score Matching Analysis

Monday, March 31, 2025
3:00 PM – 3:09 PM CT
Location: Music City Center, 207 CD
Purpose: Patients with hematologic malignancy (HC) have been reported to be at a higher risk of chest port (port) infection compared to those with solid cancers (SC) presumably due to their impaired immune systems secondary to the malignancies and the longer and more intense chemotherapeutic regimens {1,2}. However, the previous studies were retrospective in nature with possible confounding variables uncontrolled. The purpose of this study was to compare the port infection rate between HC and non-HC patients using propensity score matching and to determine if a history of HC is an independent risk factor for infection. 

Materials and Methods: A total of 3,949 consecutive adult ( >18 years old) oncologic patients (male/female: 1,947/2,002, median age: 61) who had a port placed between 2013 and 2023 were included in this study. Patients with port infections were identified through chart review. Propensity score matching generated a cohort of 372 pairs of patients for the HC and non-HC groups (74 GI, 96 Lung, 48 Breast, 42 HNC, 69 GU, 8 CNS, 10 GYN, 25 Other) that are balanced across 13 potentially confounding variables from patient demographics (age, sex, BMI, HIV status), port characteristics (laterality, clinical setting) and laboratory values (leukopenia, thrombocytopenia, hypoalbuminemia, neutropenia, coagulopathy) and medication (bevacizumab, steroids). The overall infection rate of the matched groups was compared using Poisson regression. Univariate proportional subdistribution hazard regression (PSHREG) analysis was also conducted to determine if HC was an independent risk factor for port infection. 

Results: Within the matched cohort, the cumulative follow-up period for HC ports was 261,182 catheter-days (median per patient: 475 catheter-days, range:0–3,906 catheter-days) whereas that of the non-HC ports was 193,190 catheter-days (median per patient: 368.5 catheter-days, range:9–2,774 catheter-days), P = < .0001. In the HC group, a total of 24 ports (6.49%) were found to be affected with chest port infection, while 37 ports in the non-HC group (10%) were affected with infection, accounting for infection rates of 0.09 and 0.19 infections/1000 catheter-days, respectively (P = 0.0048). Multivariate PSHREG analysis of the matched cohort further demonstrated that HC is an independent protective factor for port infection (hazard ratio = 0.55, 95% confidence interval = 0.32-0.95, P = 0.033). 

Conclusion: In this single-institution study using propensity score matching, patients with HC were at a lower risk of port infection when compared to those with non-HC.