title: Cost and Morbidity Analysis of Chest Port Insertion: Interventional Radiology Suite Versus Operating Room.
abstract: OBJECTIVE
  To compare complications and cost, from a hospital perspective, of chest port insertions performed in an interventional radiology (IR) suite versus in surgery in an operating room (OR).
  
  
  METHODS
  This study was approved by an institutional review board and is HIPAA compliant. Medical records were retrospectively searched on consecutive chest port placement procedures, in the IR suite and the OR, between October 22, 2010 and February 26, 2013, to determine patients' demographic information and chest port-related complications and/or infections. A total of 478 charts were reviewed (age range: 21-85 years; 309 women, 169 men). Univariate and bivariate analyses were performed to identify risk factors associated with an increased complication rate. Cost data on 149 consecutive Medicare outpatients (100 treated in the IR suite; 49 treated in the OR) who had isolated chest port insertions between March 2012 and February 2013 were obtained for both the operative services and pharmacy. Nonparametric tests for heterogeneity were performed using the Kruskal-Wallis method.
  
  
  RESULTS
  Early complications occurred in 9.2% (22 of 239) of the IR patients versus 13.4% (32 of 239) of the OR patients. Of the 478 implanted chest ports, 9 placed in IR and 18 placed in surgery required early removal. Infections from the ports placed in IR versus the OR were 0.25 versus 0.18 infections per 1000 catheters, respectively. Overall mean costs for chest port insertion were significantly higher in the OR, for both room and pharmacy costs (P < .0001). Overall average cost to place chest ports in an OR setting was almost twice that of placement in the IR suite.
  
  
  CONCLUSIONS
  Hospital costs to place a chest port were significantly lower in the IR suite than in the OR, whereas radiology and surgery patients did not show a significantly different rate of complications and/or infections.
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: LaRoy
authors.affiliation: Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Sarah B
authors.initials: SB
authors.lastname: White
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Thejus
authors.initials: T
authors.lastname: Jayakrishnan
authors.affiliation: Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dybul
authors.affiliation: Decision Support, Financial Department, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ungerer
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Kiran
authors.initials: K
authors.lastname: Turaga
authors.affiliation: Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: papatel@mcw.edu.
authors.forename: Parag J
authors.initials: PJ
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000191:economics*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009873:Operating Rooms / Q000191:economics*; D011183:Postoperative Complications; D015641:Radiography, Interventional / Q000191:economics*; D012189:Retrospective Studies; D012307:Risk Factors; D013909:Thorax
keywords: Chest port; central venous access; complication; cost; cost effective; interventional radiology; interventional radiology suite; operating room; port; surgery