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Supportive Care in Cancer

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01-01-2020 | Central Venous Catheter | Original Article

The risk of bloodstream infection associated with totally implantable venous access ports in cancer patient: a systematic review and meta-analysis

Authors: Meng Jiang, Chang-li Li, Chun-qiu Pan, Li Yu

Published in: Supportive Care in Cancer | Issue 1/2020

Abstract

Objective

This systematic review and meta-analysis aimed to provide evidence-based guidance to better understand the risk of central line-associated bloodstream infection (CLABSI) in cancer patients who received totally implantable venous access ports (TIVAPs) compared with those who received external central venous catheters (CVCs).

Methods

A systematic search of PubMed, Web of science, Embase, and the Cochrane Library was carried out from inception through Oct 2018, with no language restrictions. Trials examining the risk of CLABSI in cancer patients who received TIVAPs compared with those who received external CVCs were included. Two reviewers independently reviewed, extracted data, and assessed the risk of bias of each study. A random-effect model was used to estimate relative risks (RRs) with 95% CIs.

Results

In all, 26 studies involving 27 cohorts and 5575 patients reporting the incidence of CLABSI in patients with TIVAPs compared with external CVCs were included. Pooled meta-analysis of these trials revealed that TIVAPs were associated with a significant lower risk of CLABSI than were external CVCs (relative risk [RR], 0.44; 95% confidence interval [CI], 0.31–0.62; P < 0.00001), which was confirmed by trial sequential analysis for the cumulative z curve entered the futility area. Subgroup analyses demonstrated that CLABSI reduction was greatest in adult patients (RR [95% CI], 0.35 [0.22–0.56]) compared with pediatric patients who received TIVAPs (RR [95% CI], 0.55 [0.38–0.79]).

Conclusions

TIVAP can significantly reduce the risk of CLABSI compared with external CVCs.

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Title: The risk of bloodstream infection associated with totally implantable venous access ports in cancer patient: a systematic review and meta-analysis
Authors: Meng Jiang
Chang-li Li
Chun-qiu Pan
Li Yu
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Central Venous Catheter
Cytostatic Therapy
Published in: Supportive Care in Cancer / Issue 1/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-04809-x

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