Medecine et maladies infectieuses · 2008
[Incidence, prevalence and risk factors for a first infectious complication on a totally implantable venous-access port].
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Crisinel M, Mahy S, Ortega-Debalon P, Buisson M, Favre J-P, Chavanet P, Piroth L
Аннотация
BACKGROUND: Totally implantable venous-access ports (TIVAP) should present less risk of complications than central venous catheters over a long time period.
AIMS: Firstly, the study's objective was to assess the prevalence and incidence of a first infectious complication on a TIVAP and secondly, to assess the risk factors associated with this first infection.
METHODS: The authors made a longitudinal historical cohort study of patients with a TIVAP in 2003, in the Dijon University Hospital.
RESULTS: Two hundred and nineteen patients (sex-ratio 1.9) were included, with a total follow-up of 92,773 patients-days. Ninety percent of the TIVAP were used for chemotherapy, 5% for antibiotic drug administration, 2% for parenteral nutrition and 3% for other reasons (recurrent blood transfusions, etc.). Overall, 34 (16.3%) out of 209patients presented with at least one infectious complication, with an incidence rate of 0.37infection/1,000patients-days. The 5-year cumulative probability to be free of infectious complication was only 62.8%. In multivariate analysis, only underlying hematological neoplasia (by contrast with solid tumors) was significantly associated to a higher risk of infectious complication.
CONCLUSIONS: The infectious risk linked to the use of TIVAP is significant, higher in case of underlying hematological neoplasia and during the first months of use.
AIMS: Firstly, the study's objective was to assess the prevalence and incidence of a first infectious complication on a TIVAP and secondly, to assess the risk factors associated with this first infection.
METHODS: The authors made a longitudinal historical cohort study of patients with a TIVAP in 2003, in the Dijon University Hospital.
RESULTS: Two hundred and nineteen patients (sex-ratio 1.9) were included, with a total follow-up of 92,773 patients-days. Ninety percent of the TIVAP were used for chemotherapy, 5% for antibiotic drug administration, 2% for parenteral nutrition and 3% for other reasons (recurrent blood transfusions, etc.). Overall, 34 (16.3%) out of 209patients presented with at least one infectious complication, with an incidence rate of 0.37infection/1,000patients-days. The 5-year cumulative probability to be free of infectious complication was only 62.8%. In multivariate analysis, only underlying hematological neoplasia (by contrast with solid tumors) was significantly associated to a higher risk of infectious complication.
CONCLUSIONS: The infectious risk linked to the use of TIVAP is significant, higher in case of underlying hematological neoplasia and during the first months of use.