Neutropenia at the time of subcutaneous port insertion may not be a risk factor for early infectious complications in pediatric oncology patients

Abstract

BackgroundThe risk of infection associated with subcutaneous port (SQP) placement in patients with neutropenia remains unclear. We reviewed the rate of early infectious complications (<30 days) following SQP placement in pediatric oncology patients with or without neutropenia [absolute neutrophil count (ANC) <500/mm3]. MethodsBaseline characteristics and infectious complications were compared between groups using univariate and multivariate analyses. ResultsA total of 614 SQP were placed in 542 patients. Compared to nonneutropenic patients, those with neutropenia were more likely to have leukemia (n = 74, 94% vs n = 268, 50%), preoperative fever (n = 17, 22% vs n = 25, 5%), recent documented infection (n = 15, 19% vs n = 47, 9%), and were younger (81 vs 109 months) (p values <0.01). After adjusting for fever and underlying-disease, there was a nonsignificant association between neutropenia and early postoperative infection (OR 2.42, 95% CI 0.82–7.18, p = 0.11). Only preoperative fever was a predictor of infection (OR 6.09, 95% CI 2.08–17.81, p = 0.001). ConclusionSQP placement appears safe in most neutropenic patients. Type of studyRetrospective comparative study. Level of evidenceLevel III.