title: A comparison of central lines in pediatric oncology patients: Early removal and patient centered outcomes.
abstract: BACKGROUND
  While there is increasing evidence supporting the choice of subcutaneous ports (SPs) over external venous catheters (EVCs) in pediatric oncology patients, prior conflicting studies exist and little data have been gathered as to which type of central line is preferred from the patient/family perspective.
  
  
  METHODS
  We performed a single institution, 10 years, retrospective analysis of central lines in pediatric oncology patients (n = 878) to evaluate unplanned early removal and cause of removal while simultaneously obtaining a cross sectional survey of 143 of the primary caretakers/parents of these patients to evaluate their overall satisfaction with the line.
  
  
  RESULTS
  EVCs have significantly higher odds of unplanned early removal in comparison to SPs (6.7% of SPs vs. 27.3% of EVCs, odds ratio (OR) = 6.3, P < 0.0001 when controlling for age and diagnosis) secondary to increased infection, malfunction and patient preference. Patients with SPs felt like their central line was easier to care for, had less daily impact in their life, and were overall more satisfied with their central line compared to patients with EVCs, even when controlling for early removal (P < 0.0001 for all). SP patients were much more likely to state that they would choose the same type of line again (OR = 15, P < 0.0001) than EVC patients.
  
  
  CONCLUSIONS
  SPs demonstrated lower removal rates and greater patient satisfaction than EVCs. These data should be considered when choosing a central line for pediatric cancer patients.
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, Utah; Primary Children's Medical Center, Salt Lake City, Utah; Albert Einstein College of Medicine, Bronx, New York.
authors.forename: David Spencer
authors.initials: DS
authors.lastname: Mangum
authors.forename: Anupam
authors.initials: A
authors.lastname: Verma
authors.forename: Cindy
authors.initials: C
authors.lastname: Weng
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Sheng
authors.forename: Ryan
authors.initials: R
authors.lastname: Larsen
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
authors.forename: Colleen
authors.initials: C
authors.lastname: Druzgal
authors.forename: Mark
authors.initials: M
authors.lastname: Fluchel
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D002648:Child; D003430:Cross-Sectional Studies; D020878:Device Removal; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000188:drug therapy; D010372:Pediatrics; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents
keywords: central line; early unplanned removal; patient survey