1Jonathan Wakim,1Benjamin Frost, 1Benjamin Frost, 1Gregory J Nadolski, 1Terence P Gade, 1Terence P Gade, 1Stephen J. Hunt
1University of Pennsylvania
This study investigates the factors associated with port removal for malfunction in patients who underwent port removal at a high-volume tertiary academic center.
Material(s) and Method(s):
All A retrospective IRB-approved cohort of patients who underwent port removal from January 1999 to December 2019 were identified using a clinical quality improvement database and a search of radiology reports (Hi-IQ and Montage; n=5088). Manual review of the clinical record over a five-year period (2015-2019) was used to gather factors that might be associated with ports removed for malfunction (n=204) compared to those patients who went port removal for therapy completion (n=2930). Patients who had ports removed for indications other than malfunction or therapy completion (e.g., infection) were excluded from the current analysis.
Neither age (54.4 vs 54.2, p=0.8) nor gender [72% female vs 66% female, OR=0.75 (95%CI: 0.55-1.03), p=0.08] were different between the port malfunction and therapy completion cohorts. Only 3% (96/2930) of therapy completion patients had their ports removed in the inpatient setting, while 20% (40/204) of patients with port malfunction were removed as an inpatient. Metastatic cancer was more common in patients with port malfunction than therapy completion [55% vs 38%; OR=2 (95%CI: 1.3-3.3) p=0.003*]. Morbid obesity (BMI>35) was more common in patients with port malfunction than in patients who completed therapy [24% vs 16%; OR=1.73 (95%CI: 1-3) p=0.048*]. Interestingly, a lower percentage of patients who had their port removed for malfunction received chest wall radiation compared those who completed therapy [30% vs 20%; OR=0.5 (95%CI: 0.29-0.98) p=0.041*].
Port removals due to malfunction are associated with patients having metastatic cancer and in patients with severe obesity. Ports removed for malfunction are more commonly removed in the inpatient setting compared to those removed for therapy completion. Understanding the factors correlating with port malfunction can inform discussions of procedural risk and help guide clinical management to avoid unnecessary complications and allow for early prevention measures.