A comparative analysis of infection and complication rates between single- and double-lumen ports

Abstract

Abstract Objective: Port-a-caths are implanted intravascular chest ports that enable venous access. With more port placements performed by interventional radiologists, it is important to discern differences in infection and complication rates between double- and single-lumen ports. Methods: We retrospectively reviewed 1,385 port placements over 2 years at the University of Miami. Patients were grouped by single- or double-lumen ports. Data on duration of catheter stay, bloodstream infections, malfunctions, and other complications (fibrin sheath, thrombosis, catheter malposition) were collected. Multivariate Cox regression was performed to identify variables predicting port infection. Results: The mean patient age was 58.8 years; the mean BMI was 26.9 kg/m2; and 61.5% of these patients were female. Our search revealed 791 double-lumen ports (57.1%) and 594 single-lumen ports (42.9%). The median follow-up was 668 days (range, 2–1,297). Double-lumen ports were associated with significantly higher rates of bacteremia (2.78% vs 0.84%; P = .02), port malfunction (8.3% vs 2.0%; P < .001), fibrin sheath formation (2.2% vs 0.5%; P < .02), catheter tip malposition (1.0% vs 0; P = .01), and catheter-associated thrombosis (1.4% vs 0; P = .003). Multivariate Cox regression analysis, after adjusting for other variables, showed that double-lumen chest ports had 2.98 times (95% confidence interval, 1.12–7.94) the hazard rate of single-lumen ports for developing bloodstream infection (P = .029). Conclusions: Double-lumen chest ports are associated with increased risk for bloodstream infection, malfunction, fibrin sheath formation, catheter tip malposition, and catheter-associated thrombosis. Interventional radiologists may consider placing single-lumen ports if clinically feasible; however, future studies are needed to determine clinical significance. The study limitations included the retrospective study design and the potential loss of patient follow-up.