Associations between Neutropenia Status, Port Removal, and Outcomes in Patients Undergoing Chemotherapy: A National Inpatient Sample Study

To determine the association between neutropenia status and port removal, as well as their combined effects on length of hospitalization and inpatient mortality, in patients undergoing chemotherapy.


Materials and Methods: Data were obtained from the National Inpatient Sample (NIS), a national database of hospital admissions, from January 1, 2015 to December 31, 2019. The study population consisted of all patients who received chemotherapy and port placement during hospitalization, identified using ICD-10 codes. Logistic regression was used to analyze associations between neutropenia status and port removal. Additional analyses were performed to assess interaction effects between neutropenia status and port removal on length of hospitalization and inpatient mortality. Propensity score matching (PSM) with optimized full matching was performed prior to all regression analyses.

Results: Patients with neutropenia were identified using ICD-10 codes. Of 4,150 patients in the study population, 9.9% (N = 411) were diagnosed with neutropenia during hospitalization. Neutropenic patients had higher odds of port removal compared to non-neutropenic patients (OR = 3.20, 95% CI: 1.40-6.62, p-value < 0.01) after PSM adjusting for demographic variables. In patients without neutropenia, a 1-year increase in age was associated with a 5% reduction in the odds of port removal (OR = 0.95, 95% CI: 0.93-0.97, p-value < 0.01); a similar association was not observed in patients with neutropenia. Neutropenia and port removal were independent risk factors for longer hospital stays. No cases of inpatient mortality were observed among patients who underwent port removal.


Conclusion: Patients with neutropenia were at 220% higher odds of port removal compared to patients without neutropenia, after propensity score matching by demographic variables. We found evidence of interaction between neutropenia and age, with a one-year increase in age associated with a 5% reduction in the odds of port removal among patients without neutropenia but 0% reduction in the odds of port removal among patients with neutropenia. Both neutropenia and port removal were risk factors associated with longer hospitalizations.