Removal of Chest Ports for Infection: Risk in Patients with a History of Prior Port Removal for Infection.

Purpose: To compare the rate of port removal due to infection between patients with a history of port removal (prior-infection group) and those without (no-prior-infection group), and to determine if a history of port removal due to infection is an independent risk factor for port removal due to infection.

Methods: This single-institution retrospective study identified 3,965 ports placed in 3,825 patients from 2013 to 2022, including 80 ports in patients with a history of port removal due to infection. Port infections (port site infection and bloodstream infection) requiring removal were recorded through chart review. Infection rates were compared using Poisson regression. Multivariate proportional subdistribution hazards regression (PSHREG) analysis was conducted to determine whether a history of port removal due to infection is an independent risk factor for port removal due to infection.

Results: Total follow-up period was 1,912,995 catheter-days (median: 488, range: 1-3,405 days). The rate of port removal due to infection in the prior-infection group was significantly higher than that in the non-prior-infection group (0.74 vs. 0.13 per 1,000 catheter-days, P<0.0001). Multivariate PSHREG analysis identified a history of port removal due to infection was an independent risk factor for port removal due to infection (subdistribution hazard ratio, 4.59; 95% CI, 2.89-7.33; P<.0001). These observations were noted in non-oncology patients, but not in oncology patients.

Conclusions: A history of port removal due to infection was associated with a higher risk of another port removal due to infection. This did not appear to be applicable to oncology patients.