title: Accessing totally implantable venous access systems on the day of placement does not significantly increase the risk of infection.
abstract: OBJECTIVE
  Totally implantable venous access systems (ports) are commonly placed and have a low complication rate. The most common complication is infection, which can have very negative effects on patients resulting in hospitalization and/or treatment delay in the setting of neoplasm. While a number of variables have been studied in relation to diminishing infectious rates, one remaining question is the effect of accessing the port on day of placement, which is the aim of this retrospective study.
  
  
  METHODS
  After internal review board approval the electronic medical records of 2,006 patients who underwent port placement between 10/1/2008 and 9/30/2013 were reviewed. Of these patients 628 were excluded as they did not have complete placement and removal data available, leaving 1378 patients in our cohort.
  
  
  RESULTS
  There was a significantly longer number of infection-free catheter days in the out-patient cohort as compared to the in-patient cohort (p = 0.027). In-patients mean day after placement when the port was first accessed (DAP) (0.5) was statistically earlier (closer to placement) than the out-patients DAP (7.2) (p&lt;0.0001). However, the increased likelihood of infection could not be explained by DAP (p = 0.2029) even when controlling for in-patient and out-patient status (p = 0.97).
  
  
  CONCLUSIONS
  Accessing the port on the day of placement does not significantly contribute to an increased likelihood of infection. This study seems to indicate that placing a port on the first day of outpatient therapy likely optimally balances respect for patient time with infection control.
authors: Department of Diagnostic Radiology, University of Florida, Gainesville, Florida - USA.
authors: Shamar J
authors: SJ
authors: Young
authors: Department of Statistics, University of Florida, Gainesville, Florida - USA.
authors: Linda J
authors: LJ
authors: Young
authors: Department of Diagnostic Radiology, University of Florida, Gainesville, Florida - USA.
authors: Jeffery
authors: J
authors: Vogel
authors: Department of Diagnostic Radiology, University of Florida, Gainesville, Florida - USA.
authors: Raymond
authors: R
authors: Sutkowski
authors: Department of Diagnostic Radiology, University of Florida, Gainesville, Florida - USA.|National Pain Institute, Lady Lake, Florida - USA.
authors: Satish
authors: S
authors: Venkataperumal
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology*; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D057286:Electronic Health Records; D005260:Female; D005431:Florida; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents