Neutropenia at the time of subcutaneous port insertion may not be a risk factor for early infectious complications in pediatric oncology patients

皮下输液港植入时中性粒细胞减少症可能并非儿童肿瘤患者早期感染并发症的危险因素

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Abstract

BACKGROUND: The risk of infection associated with subcutaneous port (SQP) placement in patients with neutropenia remains unclear. We reviewed the rate of early infectious complications (<30 days) following SQP placement in pediatric oncology patients with or without neutropenia [absolute neutrophil count (ANC) <500/mm(3)]. METHODS: Baseline characteristics and infectious complications were compared between groups using univariate and multivariate analyses. RESULTS: A total of 614 SQP were placed in 542 patients. Compared to nonneutropenic patients, those with neutropenia were more likely to have leukemia (n = 74, 94% vs n = 268, 50%), preoperative fever (n = 17, 22% vs n = 25, 5%), recent documented infection (n = 15, 19% vs n = 47, 9%), and were younger (81 vs 109 months) (p values <0.01). After adjusting for fever and underlying-disease, there was a nonsignificant association between neutropenia and early postoperative infection (OR 2.42, 95% CI 0.82-7.18, p = 0.11). Only preoperative fever was a predictor of infection (OR 6.09, 95% CI 2.08-17.81, p = 0.001). CONCLUSION: SQP placement appears safe in most neutropenic patients. TYPE OF STUDY: Retrospective comparative study. LEVEL OF EVIDENCE: Level III.

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