Abstract No. 299 Are Patients with Head and Neck Cancer at Higher Risk for Chest Port Infection Compared with Patients with Non-Head and Neck Cancer? Propensity Score Matching Analysis

Patients with head and neck cancer (HNC) have been reported to be at a higher risk of chest port (port) infection compared to those with non-HNC due to tracheostomy or local irradiation. However, the previous studies were retrospective in nature with possible confounding variables uncontrolled. The purpose of this study was to compare the port-related infection rate between HNC and non-HNC patients using propensity score matching and to determine if a history of HNC is an independent risk factor for infection. A total of 3,757 consecutive adult ( >18 years old) oncologic patients (male/female: 1,872/1,885, median age: 62) who had a port placed between 2013 and 2022 were included in this study. Patients with port infections (port site infection and port-related blood stream infection) were identified through chart review. Propensity score matching generated a cohort of 307 pairs of patients for the HNC and non-HNC groups (54 GI, 88 Lung, 44 Breast, 50 Hematological, 54 GU, 1 CNS, 9 GYN, 7 Other) that are balanced across 14 potentially confounding variables from patient demographics (age, sex, inpatient vs. outpatient), port characteristics (laterality, lumen number, catheter tip location, prior treatment, prior port removal and its reason) and laboratory values (leukopenia, neutropenia, hypoalbuminemia) and medication (steroids, bevacizumab). The overall infection rate of the matched groups was compared using Poisson regression. Univariate proportional subdistribution hazard regression (PSHREG) analysis was also conducted to determine if HNC was an independent risk factor for port infections. Within the matched cohort, the cumulative follow-up period for HNC ports was 137,438 catheter-days (median per patient: 223 catheter-days, range:1–2,879 catheter-days) whereas that of the non-HNC ports was 133,565 catheter-days (median per patient: 343 catheter-days, range:1–1,931 catheter-days (P = 0.4530)). In the HNC group, a total of 23 ports (7.5%) were found to be affected with infections, while 25 ports in the non-HNC group (8.1%) were affected with infections, accounting for infection rates of 0.16 and 0.18 infections/1000 catheter-days, respectively (P = 0.9032). PSHREG analysis of the matched cohort further demonstrated that HNC is not an independent risk factor for port infection (hazard ratio = 0.895, 95% confidence interval = 0.511-1.568, P = 0.6979). In this single-institution study using propensity score matching, patients with HNC were not at a higher risk of port infections when compared to those with non-HNC.