3:27 PM Abstract No. 358 Increased port catheter related infection rates in inpatients with longer pre- and post procedure stays

To compare early port catheter related infection rates in inpatients versus outpatients, and to determine whether the risk with inpatient placement is influenced by length of hospital stay. In this single-institution retrospective study, 5301 patients (n = 3618 female; mean age=57) underwent port placement by interventional radiology between October 2004 and January 2018. Early port infection was defined as removal for clinically suspected infection within 30 days of placement. Infection risk was compared between inpatients and outpatients using survival analysis. Among inpatients, the effect of time from admission to port placement and from placement to discharge was analyzed using a survival regression tree. The 30 day infection risk was 3.6% (CI = 1.9-6.1%) among 386 inpatients and 1.0% (CI = 0.7-1.3%) among 4915 outpatients (HR = 3.6, CI = 2.0-6.6, P <0.001). Among infections with positive blood cultures, 8 occurred after inpatient placement (30 day risk = 2.2%, CI = 1.0-4.3%) and 28 after outpatient placement (30-day risk = 0.6%, CI = 0.4-0.8%) (HR = 3.9, CI = 1.8-8.5, P <0.001). Inpatient placement was a significant risk factor after accounting for covariates in multivariate analysis (HR = 2.2, CI = 1.0-4.7, P = 0.05) and controlling for demographic differences by propensity score matching (HR = 2.8, CI = 1.0-7.8, P = 0.04). Early infection risk was 11% (CI = 4.7-22%) among 65 inpatients admitted ≥7 days before placement, 5.1% (CI = 1.9-11%) among 129 inpatients admitted 3 days, and 0% (CI = 0-2.1%) among 192 in patients in whom admission to placement was <7 days and time to discharge was ≤3 days (P <0.001). Inpatient port placement was associated with higher risk of early infection. However, a clinical decision tree based on shorter length of stay prior to and after port placement may identify a subset of inpatients not at increased infection risk.