Comparison of PICC versus PICC-port in terms of complications and cost-effectiveness in nasopharyngeal carcinoma patients: A randomized controlled trial

Abstract

Objective:

To compare the peripherally inserted central catheter (PICC) and a new type of arm-port, the PICC-port, in patients with nasopharyngeal cancer in terms of complications and cost-effectiveness.

Methods:

A randomized controlled trial was conducted with a total of 126 patients. The patients were randomly assigned to the experimental group or the control group. The outcomes were observed from the day of placement until extubation. Demographic data, data related to catheter placement, and the placement effects were collected and analyzed using SPSS 29.0.

Results:

Catheters were successfully inserted in 123 out of the 126 patients (61 in the experimental group and 62 in the control group). Compared with the control group, the experimental group had a lower incidence of complications after placement (21.3% vs 54.8%, p < 0.001). This included lower incidences of catheter dislodgement (0% vs 21.0%, p < 0.001), catheter occlusion (1.6% vs 12.9%, p = 0.032), wound oozing (4.9% vs 33.9%, p < 0.001), and medical adhesive-related skin injury (4.9% vs 14.9%, p = 0.025). Additionally, the severity of both wound oozing (p < 0.001) and medical adhesive-related skin injury (p = 0.014) was lower in the experimental group. Although the surgical cost was higher in the experimental group, the PICC-ports required less maintenance and the patients’ quality of life coefficient was higher. When considering overall healthcare costs and health outcomes, the net benefits became equal between the two groups after 2.8 months. Beyond this point, the net benefits of the experimental group surpassed those of the control group, with the difference increasing as the dwelling time of the catheter increased.

Conclusion:

For patients with nasopharyngeal carcinoma requiring long-term treatment (duration >3 months), PICC-ports may be the preferred option compared to PICCs, particularly for those unable to undergo regular catheter maintenance or prioritizing quality of life.