title: Outcomes, cost comparison, and patient satisfaction during long-term central venous access in cancer patients: Experience from a Tertiary Care Cancer Institute in South India.
abstract: BACKGROUND
  Prolonged treatment, frequent administration of chemotherapy, antibiotics and blood products in cancer patients requires long term venous access. Central venous catheters (CVC) inserted into the subclavian vein or internal jugular vein, peripherally inserted central venous catheters (PICC) and chemoport (CP) are the commonly used central venous access devices (CVAD).
  
  
  OBJECTIVE
  This study was envisaged to review our experience of CVADs over a one year period and analyze the outcome with regard to catheter life, reasons for removal, complications, patient satisfaction and cost comparison between the CVAD types in the Indian setting.
  
  
  METHODS
  This was a prospective, observational study carried out in a tertiary care cancer institute.
  
  
  METHODS
  180 CVADs placed in patients with hematological malignancies and solid tumors from January 2014 to December 2014 were included.
  
  
  METHODS
  Data was analyzed using descriptive statistics, Mann Whitney U test.P<0.05 was taken as statistically significant.
  
  
  RESULTS
  180 CVADs were placed in 160 patients. The median catheter indwelling period was 76 days (16 days to 313 days) for CVC, 59 days (20days - 313 days) for PICC and 137 days (70 days - 258 days) for CP. 66 out of 160 patients developed complications (41.2%). 108 complication events were noted in 66 patients. There were 40 episodes of CRBSI. Out of the 68 mechanical complications, 37 were encountered during insertion of the CVAD and 31 were during the catheter indwelling period. Out of 160 patients, 138 (86.25%) were satisfied with the CVAD. The cost incurred for CVC/PICC (INR 4,480) was lower than that for CP (INR 24,150) and it was statistically significant (P< 0.0001). Our patients were highly satisfied with the CVAD.
  
  
  CONCLUSIONS
  Use of CVC and PICC is a safe, reliable and cost saving way of administration of chemotherapy in developing countries. The incidence of complications and catheter loss was acceptable. Our patients were highly satisfied with the CVAD.
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
authors.forename: K Govind
authors.initials: KG
authors.lastname: Babu
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
authors.forename: M C
authors.initials: MC
authors.lastname: Suresh Babu
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
authors.forename: D
authors.initials: D
authors.lastname: Lokanatha
authors.affiliation: Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
authors.forename: Gita R
authors.initials: GR
authors.lastname: Bhat
keywords: Central venous catheters; chemoport; complications; cost comparison; patient satisfaction; peripherally inserted central venous catheter