The risk of bloodstream infection associated with totally implantable venous access ports in cancer patient: a systematic review and meta-analysis
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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).
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.
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]).
TIVAP can significantly reduce the risk of CLABSI compared with external CVCs.
KeywordsTotally implantable venous access ports External central venous catheters Central line-associated bloodstream infection Meta-analysis
This work was supported by grants from the President Foundation of Nanfang Hospital of Southern Medical University (Grant No.2016B012) and grants from President Foundation of Nanfang Hospital, Southern Medical University (CX2018NO13).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests. We have full control of all primary data and agree to allow the journal to review our data if requested.
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