title: Severe Neutropenia at the Time of Implantable Subcutaneous Chest Port Insertion Is Not a Risk Factor for Port Removal at a Tertiary Pediatric Center.
abstract: OBJECTIVE
  To determine if severe neutropenia at the time of chest port insertion is a risk factor for port removal and central catheter-associated bloodstream infection (CCABSI) in pediatric patients.
  
  
  METHODS
  From May 2007 to June 2015, 183 consecutive patients (mean age, 9.9 y; range, 0.75-21 y) had a port inserted at a single tertiary pediatric center. Seventy-two had severe neutropenia at the time of port insertion (absolute neutrophil count [ANC] range, 0-500/mm3; mean, 185/mm3). Follow-up until port removal or death and CCABSI events were recorded.
  
  
  RESULTS
  Within the first 30 days, similar incidences of CCABSI (12.5% of patients with severe neutropenia [n = 9] vs 4.5% of patients without [n = 5]), port removal for infection (2.8% [n = 2] vs 2.7% [n = 3]), and local port infection (2.8% [n = 2] vs 0.9% [n = 1]) were observed in both groups (P > .05), but the rate of CCABSI per 1,000 catheter-days was higher for patients with severe neutropenia (P = .045). Overall, similar incidences of CCABSI (18.1% [n = 13] vs 16.2% [n = 18]), port removal for infection (2.8% [n = 2] vs 7.2% [n = 8]), local port infection (2.8% [n = 2] vs 2.7% [n = 3]), and CCABSIs per 1,000 catheter-days (0.332 vs 0.400) were observed in both groups (P > .05).
  
  
  CONCLUSIONS
  Port placement in patients with severe neutropenia can be performed without an increased incidence of port removal for infection. The majority of CCABSIs were successfully treated without port removal.
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354. Electronic address: dhoss@llu.edu.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Hoss
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354.
authors.forename: Antranik A
authors.initials: AA
authors.lastname: Bedros
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354.
authors.forename: Avinash
authors.initials: A
authors.lastname: Mesipam
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354.
authors.forename: Jared
authors.initials: J
authors.lastname: Criddle
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D009503:Neutropenia / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents