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J Vasc Interv Radiol ; 28(3): 398-402, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28034702

ABSTRACT

PURPOSE: To determine if severe neutropenia at the time of chest port insertion is a risk factor for port removal and central catheter-associated bloodstream infection (CCABSI) in pediatric patients. MATERIALS AND METHODS: From May 2007 to June 2015, 183 consecutive patients (mean age, 9.9 y; range, 0.75-21 y) had a port inserted at a single tertiary pediatric center. Seventy-two had severe neutropenia at the time of port insertion (absolute neutrophil count [ANC] range, 0-500/mm3; mean, 185/mm3). Follow-up until port removal or death and CCABSI events were recorded. RESULTS: Within the first 30 days, similar incidences of CCABSI (12.5% of patients with severe neutropenia [n = 9] vs 4.5% of patients without [n = 5]), port removal for infection (2.8% [n = 2] vs 2.7% [n = 3]), and local port infection (2.8% [n = 2] vs 0.9% [n = 1]) were observed in both groups (P > .05), but the rate of CCABSI per 1,000 catheter-days was higher for patients with severe neutropenia (P = .045). Overall, similar incidences of CCABSI (18.1% [n = 13] vs 16.2% [n = 18]), port removal for infection (2.8% [n = 2] vs 7.2% [n = 8]), local port infection (2.8% [n = 2] vs 2.7% [n = 3]), and CCABSIs per 1,000 catheter-days (0.332 vs 0.400) were observed in both groups (P > .05). CONCLUSIONS: Port placement in patients with severe neutropenia can be performed without an increased incidence of port removal for infection. The majority of CCABSIs were successfully treated without port removal.


Subject(s)
Antineoplastic Agents/administration & dosage , Catheter-Related Infections/surgery , Catheterization, Central Venous/adverse effects , Catheters, Indwelling , Central Venous Catheters/adverse effects , Device Removal , Neoplasms/drug therapy , Neutropenia/complications , Tertiary Care Centers , Adolescent , Catheter-Related Infections/diagnosis , Catheter-Related Infections/microbiology , Catheterization, Central Venous/instrumentation , Child , Child, Preschool , Equipment Design , Female , Humans , Infant , Male , Neoplasms/complications , Neoplasms/diagnosis , Neutropenia/diagnosis , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Time Factors , Treatment Outcome , Young Adult
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