Factors associated with unscheduled venous access port removal in cancer patients

Abstract

Aims: Implantable venous access ports (IVAP) are used in cancer patients to provide central venous circulation access. This study investigated the prognostic factors for IVAP removal among cancer patients. Methods: A retrospective cohort study was conducted on cancer patients implanted with IVAP in the Hospital Universiti Sains Malaysia and followed up with at least one cycle of chemotherapy. The primary endpoint was unscheduled IVAP removal due to complications. Kaplan-Meier curves were used to estimate removal probability, and the log-rank test and Cox proportional hazards regression model were used to explore independent predictors. Results: A total of 205 patients were included [mean, standard deviation (SD) age: 31.55 (22.45)]. More than half of the patients were male (53.2%) and of Malay ethnicity (91.2%). During the observation period, 222 IVAPs were implanted in 205 patients with predominantly solid cancers. During the mean follow-up of 15.03 (SD: 18.45) months, 28 complications were recorded. Prognostic factors for unscheduled IVAP removal were kidney disease [hazard ratio (HR): 8.33; 95% confidence interval (CI): 2.78, 24.90; p<0.001] and receiving no radiotherapy (HR: 5.25; 95% CI: 1.44, 19.11; p<0.012). Conclusions: Cancer patients with kidney disease records or those who were not planned for radiotherapy were at higher risk of unscheduled IVAP removal.

Keywords

• cancer
• chemotherapy
• complication
• catheter
• port
• vascular access device