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KMID : 0939920140460030250
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대한암학회지
2014 Volume.46 No. 3 p.250 ~ p.260
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A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection
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Lee Guk-Jin
Hong Sook-Hee
Roh Sang-Young
Park Sa-Rah
Lee Myung-Ah
Chun Hoo-Geun
Hong Young-Seon
Kang Jin-Hyoung
Kim Sang-Il
Kim Youn-Jeong
Chun Ho-Jong
Oh Jung-Suk
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Abstract
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Purpose: To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer.
Materials and Methods: A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time.
Results: CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047).
Conclusion: In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
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KEYWORD
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Neoplasms, Catheter-related infections, Risk factors
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