Abstract No. 298 Is There Any Elevated Risk of Port Infection in Patients with a History of Prior Port Removal Due to Infection?

Patients whose treatment is interrupted due to premature port removal secondary to port infection may also need a second port to complete the planned course of treatment. However, the risk of infection of the second port has not been well studied. Here, we retrospectively compare the port infection rate in patients with a history of prior port removal related to infection with those without, and to elucidate if a history of port removal related to infection is an independent risk factor for port infection. A total of 3,965 ports placed in 3,825 patients between 2013 and 2022 were included in this single-institution retrospective study. Among these, 80 patients had a history of prior port removal due to infection. Patients who had port infections were recorded through chart review. Port infection included port site infection and port-related blood stream infection (BSI). Patients with a history of prior port removal due to infection were also recorded. The patient characteristics (age, gender, BMI, diabetes, type of pathology, steroid / anticoagulant/ antiplatelet agent use, leukopenia /neutropenia/ thrombocytopenia/ hypoalbuminemia at the time of port placement) and port characteristics (right vs. left, lumen number, catheter tip location, and prior port removal) were recorded. The overall infection rate of patients with a history of port infection (prior port infection group) was compared to those without (no prior port infection group) using Poisson regression. Multivariate proportional subdistribution hazards regression (PSHREG) was used to determine if a history of prior port removal due to infection is an independent risk factor for port infection. The study covered 1,912,995 catheter-days (median per patient: 488 catheter-days, range: 1-3,405 catheter-days). A total of 331 patients developed port-related infections (8.348%, 0.173 infections/1000 catheter days), the median time to infection was 130 days (range: 1-2651 days). Among the prior port infection group, a total of 26 ports (26/80, 32.5%) were associated with infection, while 305 ports (305/3885, 7.6%) in the no prior port infection group were associated with infection, accounting for complication rates of 0.85 and 0.16 complications/1000 catheter-days, respectively (P ≤ 0.0001). PSHREG analysis further demonstrated prior removal due to infection to be an independent risk for port infection (hazard ratio 4.11, 95% confidence interval 2.70-6.25, P< 0.0001). Patients with a history of prior port removal due to infection appear to be at higher risk of second port infection.