Risk factors for skin erosion over a central venous access port: Multivariate analysis in adult oncologic patients

Abstract

Background:

Skin erosion over central venous access port (port skin erosion) is an uncommon complication; however, it usually necessitates port removal. This study retrospectively investigated risk factors for port skin erosion.

Methods:

A total of 3776 adult (⩾18 years) patients (male/female, 1841/1935; mean age, 60 years) who had ports placed at a single academic institution between January 2013 and January 2022 were included in the study. Of these, 3590 had a history of cancer, while 186 patients had a non-oncologic history. Port skin erosion was defined as a condition where any part of the port is exposed to ambient atmosphere through a breach in skin without clinical signs of local infection. Proportional subdistribution hazards regression analysis was conducted to elucidate risk factors for port skin erosion.

Results:

Cumulative follow-up period was 1,895,383 catheter-days (range 1–3405 days). A total of 45 patients (1.2%) had port skin erosion (rate 0.03/1000 catheter-days). The median time to port skin erosion was 188 catheter-days (range 32–1877 days). Multivariate analysis identified underweight (body mass index (BMI) < 18.5 kg/m²) at the time of port placement (hazard ratio (HR) = 4.24, 95% confidence interval (CI) = 1.77–10.15, p = 0.001), use of a double lumen port (HR = 2.29, 95% CI = 1.18–4.48, p = 0.02), and central nervous system (CNS) malignancy (HR = 7.12, 95% CI = 2.19–23.19, p = 0.001) as significant risk factors for port skin erosion.

Conclusions:

Underweight patients (BMI < 18.5 kg/m²), the use of a double lumen port, and CNS malignancy were independent risk factors for port skin erosion.