Long-Term Central Venous Catheter Use Associated With Three- to Sixfold Increased Risk of Infection in Older Patients With Cancer
In a retrospective SEER (Surveillance, Epidemiology, and End Results)/Medicare data analysis reported in the Journal of Clinical Oncology, Lipitz-Snyderman et al found that long-term central venous catheter use was associated with a three- to sixfold increase in risk of infection in older patients with different cancers.
Study Details
The study involved patients aged > 65 years diagnosed from 2005 to 2007 with invasive colorectal cancer (central venous catheter = 9,692, no central venous catheter = 26,580), head and neck cancer (central venous catheter = 1,399, no central venous catheter = 7,120), lung cancer (central venous catheter = 11,812, no central venous catheter = 44,958), pancreatic cancer (central venous catheter = 2,744, no central venous catheter = 7,792), non-Hodgkin lymphoma (central venous catheter = 4,292, no central venous catheter = 10,140), or invasive or noninvasive breast cancer (central venous catheter = 5,420, no central venous catheter = 36,851).
Long-term central venous catheter use was defined as use of tunneled catheters (eg, Hickman), implanted catheters (eg, ports or pumps), and peripherally inserted central catheters, regardless of actual duration of use.
Increased Risk
In analysis adjusting for age, sex, race, marital status, median income, geographic region, metropolitan location, disease stage, Romano-Charlson comorbidity index, surgery, chemotherapy, radiation therapy, and total parenteral nutrition, long-term central venous catheter use was associated with significantly increased risk of infection vs no long-term central venous catheter use in patients with breast cancer (16% vs 3%, hazard ratio [HR] = 6.19, 95% confidence interval [CI ] = 5.42–7.07), non-Hodgkin lymphoma (31% vs 12%, HR = 4.75, 95% CI = 4.32–5.23), head and neck cancer (29% vs 9%, HR = 4.47, 95% CI = 3.76–5.31), colorectal cancer (16% vs 9%, HR = 3.49, 95% CI = 3.18–3.81), lung cancer (22% vs 9%, HR = 3.23, 95% CI = 3.03–3.45), and pancreatic cancer (28% vs 13%, HR = 2.93, 95% CI = 2.58–3.33).
Findings were similar when the model was also adjusted by propensity score for receiving a central venous catheter and when analysis was limited to patients at high risk of infection.
The investigators concluded, “Long-term [central venous catheter] use was associated with an increased risk of infections for older adults with cancer. Careful assessment of the need for long-term [central venous catheters] and targeted strategies for reducing infections are critical to improving cancer care quality.”
Allison Lipitz-Snyderman, PhD, of Memorial Sloan Kettering Cancer Center, is the corresponding author for the Journal of Clinical Oncology article.
The study was supported by the National Cancer Institute. The study authors reported no potential conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
