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The Impact of Tunneled Catheters for Ascites and Peritoneal Carcinomatosis on Patient Rehospitalizations

  • Chuanxing Qu
  • Minzhi Xing
  • Anish Ghodadra
  • Kevin M. McCluskey
  • Ernesto Santos
  • Hyun S. KimEmail author
Clinical Investigation

Abstract

Purpose

The aim of the study is to assess patient outcomes, complications, impact on rehospitalizations, and healthcare costs in patients with malignant ascites treated with tunneled catheters.

Materials and Methods

A total of 84 patients with malignant ascites (mean age, 60 years) were treated with tunneled catheters. Patients with peritoneal carcinomatosis and malignant ascites treated with tunneled drain catheter placement over a 3-year period were studied. Overall survival from the time of ascites and catheter placement were stratified by primary cancer and analyzed using the Kaplan–Meier method. Complications were graded by the Common Terminology Criteria for Adverse Events v3.0 (CTCAE). The differences between pre- and post-catheter admissions, hospitalizations, and Emergency Department (ED) visits, as well as related inpatient expenses were compared using paired t tests.

Results

There were no significant differences in gender, age, or race between different primary cancer subgroups. One patient (1 %) developed bleeding (CTCAE-2). Four patients (5 %) developed local cellulitis (CTCAE-2). Three patients (4 %) had prolonged hospital stay (between 7 and 10 days) to manage ascites-related complications such as abdominal distention, discomfort, or pain. Comparison between pre- and post-catheter hospitalizations showed significantly lower admissions (−1.4/month, p < 0.001), hospital stays (−4.2/month, p = 0.003), and ED visits (−0.9/month, p = 0.002). The pre- and post-catheter treatment health care cost was estimated using MS-DRG IPPS payment system and it demonstrated significant cost savings from decreased inpatient admissions in post-treatment period (−$9535/month, p < 0.001).

Conclusions

Tunneled catheter treatment of malignant ascites is safe, feasible, well tolerated, and cost effective. Tunneled catheter treatment may play an important role in improving patients’ quality of life and outcomes while controlling health care expenditures.

Keywords

Tunneled catheter Malignant ascites Overall survival Rehospitalizations Health care cost 

Notes

Funding

None.

Compliance with Ethical Standards

Conflict of Interest

All authors have no financial or other disclosures or relationship with any commercial organization that may have a direct or indirect interest in this manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2015

Authors and Affiliations

  • Chuanxing Qu
    • 1
  • Minzhi Xing
    • 2
  • Anish Ghodadra
    • 1
  • Kevin M. McCluskey
    • 1
  • Ernesto Santos
    • 1
  • Hyun S. Kim
    • 1
    • 2
    • 3
    Email author
  1. 1.Division of Interventional Radiology, Department of RadiologyUniversity of Pittsburgh School of MedicinePittsburghUSA
  2. 2.Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale Cancer CenterYale University School of MedicineNew HavenUSA
  3. 3.Yale Cancer CenterNew HavenUSA

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