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Supportive Care in Cancer
Published in: Supportive Care in Cancer 4/2016

01-04-2016 | Original Article

Morbidity-mortality conference for adverse events associated with totally implanted venous access for cancer chemotherapy

Authors: Véronique Merle, Hélène Marini, Frédéric Di Fiore, Marion Lottin, Christian Gray, Agnès Loeb, Akpéné Fred, Nathalie Contentin, Jean-François Muir, Luc Thiberville, Christian Pfister, Emmanuel Huet, Christophe Peillon, Pierre Michel, Pierre Czernichow

Published in: Supportive Care in Cancer | Issue 4/2016

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Abstract

Purpose

Although considered safer than central venous catheters for administration of cancer chemotherapy, totally implanted venous access (TIVA) is associated with adverse events that may impair prognosis and quality of life of patients receiving chemotherapy. Our aim was to assess the feasibility and interest of surveillance of cancer chemotherapy TIVA-adverse events (AE), associated with morbidity-mortality conferences (MMCs) on TIVA-AE.

Methods

We performed a prospective interventional study in two hospitals (a university hospital and a comprehensive care center). For each cancer chemotherapy care pathway within each hospital, we set up surveillance of TIVA-AE and MMC on these events. Patients included in surveillance were those with a TIVA either placed or used for chemotherapy cycles in one of the participating wards. Feasibility of MMC was assessed by the number of MMC meetings that actually took place and the number of participants at each meeting. The interest of MMC was assessed by the number of TIVA-AE identified and analyzed, and the number and type of improvement actions selected and actually implemented.

Results

We recorded 0.41 adverse events per 1000 TIVA-day. MMCs were implemented in all care pathways, with sustained pluriprofessional attendance throughout the survey; 39 improvement actions were identified during meetings, and 18 were actually implemented.

Conclusions

Surveillance of TIVA-AE associated with MMC is feasible and helps change practices. It could be useful for improving care of patients undergoing cancer chemotherapy.
Literature
1.
Bow EJ, Kilpatrick MG, Clinch JJ (1999) Totally implantable venous access ports systems for patients receiving chemotherapy for solid tissue malignancies: a randomized controlled clinical trial examining the safety, efficacy, costs, and impact on quality of life. J Clin Oncol 17:1267PubMed
2.
Barbut F, Soukouna S, Lalande V, Garcia ML, Neyme D, de Gramont A, Petit JC (2004) Totally implantable venous access ports: frequency of complications and analysis of bacterial contamination after ablation. Pathol Biol 52:566–574CrossRefPubMed
3.
Hoareau-Gruchet F, Rtail R, Sulaj H, Khirnetkina A, Reyt E, Righini CA (2009) Complications after insertion of a totally implantable venous access port in patients treated with chemotherapy for head and neck squamous cell carcinoma. Ann Otolaryngol Chir Cervicofac 126:43–52CrossRefPubMed
4.
Nishinari K, Wolosker N, Bernardi CV, Yazbek G (2010) Totally implantable ports connected to valved catheters for chemotherapy: a single-centre prospective analysis. J Vasc Access 11:17–22PubMed
5.
Heibl C, Trommet V, Burgstaller S, Mayrbaeurl B, Baldinger C, Koplmüller R, Kühr T, Wimmer L, Thaler J (2010) Complications associated with the use of port-a-caths in patients with malignant or haematological disease: a single-centre prospective analysis. Eur J Cancer Care 19:676–681CrossRef
6.
Dal Molin A, Rasero L, Guerretta L, Perfetti E, Clerico M (2011) The late complications of totally implantable central venous access ports: the results from an Italian multicenter prospective observation study. Eur J Oncol Nurs 15:377–381CrossRefPubMed
7.
Ahn SJ, Kim HC, Chung JW, An SB, Yin YH, Jae HJ, Park JH (2012) Ultrasound and fluoroscopy-guided placement of central venous ports via internaljugular vein: retrospective analysis of 1254 port implantations at a single center. Korean J Radiol 13:314–323PubMedCentralCrossRefPubMed
8.
La situation du cancer en France en (2012) Collection état des lieux et des connaissances (in French). Boulogne-Billancourt, France, INCa Eds, 212–232
9.
Schwarz RE, Groeger JS, Coit DG (1997) Subcutaneously implanted central venous access devices in cancer patients: a prospective analysis. Cancer 79:1635–1640CrossRefPubMed
10.
Carlo JT, Lamont JP, McCarty TM, Livingston S, Kuhn JA (2004) A prospective randomized trial demonstrating valved implantable ports have fewer complications and lower overall cost than nonvalved implantable ports. Am J Surg 188:722–727CrossRefPubMed
11.
Kreis H, Loehberg CR, Lux MP et al (2007) Patients’ attitudes to totally implantable venous access port systems for gynecological or breast malignancies. Eur J Surg Oncol 33:39–43CrossRefPubMed
12.
Biffi R, de Braud F, Orsi F, Pozzi S, Mauri S, Goldhirsch A, Nolè F, Andreoni B (1998) Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 9:767–773CrossRefPubMed
13.
Anderson CI, Nelson CS, Graham CF, Mosher BD, Gohil KN, Morrison CA, Schneider PD, Kepros JP (2012) Disorganized care: the findings of an iterative, in-depth analysis of surgical morbidity and mortality. J Surg Res 177:43–48CrossRefPubMed
14.
Schwarz D, Schwarz R, Gauchan B, Andrews J, Sharma R, Karelas G, Rajbhandari R, Acharya B, Mate K, Bista A, Bista MG, Sox C, Smith-Rohrberg Maru D (2011) Implementing a systems-oriented morbidity and mortality conference in remote rural Nepal for quality improvement. BMJ Qual Saf 20:1082–1088PubMedCentralCrossRefPubMed
15.
Bal G, David S, Sellier E, François P (2010) Value of morbidity and mortality review conferences for physician education and improvement of care quality and safety: a literature review. Presse Med 39:161–168CrossRefPubMed
16.
Antonacci AC, Lam S, Lavarias V, Homel P, Eavey RA (2009) A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part II. J Surg Res 153:95–104CrossRefPubMed
17.
Marini H, Merle V, Derrey S, Lebaron C, Josset V, Langlois O, Gilles Baray M, Frébourg N, Proust F, Czernichow P (2012) Surveillance of unplanned return to the operating theatre in neurosurgery combined with a mortality--morbidity conference: results of a pilot survey. BMJ Qual Saf 21:432–438CrossRefPubMed
Metadata
Title
Morbidity-mortality conference for adverse events associated with totally implanted venous access for cancer chemotherapy
Authors
Véronique Merle
Hélène Marini
Frédéric Di Fiore
Marion Lottin
Christian Gray
Agnès Loeb
Akpéné Fred
Nathalie Contentin
Jean-François Muir
Luc Thiberville
Christian Pfister
Emmanuel Huet
Christophe Peillon
Pierre Michel
Pierre Czernichow
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2969-1

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