Neutropenia at the time of subcutaneous port insertion may not be a risk factor for early infectious complications in pediatric oncology patients

Lisa T. VanHouwelingen, Laura V. Veras, Martin Lu, Lynn Wynn, John Wu, Hasmukh Prajapati, Robert Gold, Andrew J. Murphy, Israel Fernandez-Pineda, Ankush Gosain, Ching Hon Pui, Andrew M. Davidoff

Research output: Contribution to journalArticle

Abstract

Background: The risk of infection associated with subcutaneous port (SQP) placement in patients with neutropenia remains unclear. We reviewed the rate of early infectious complications (< 30 days) following SQP placement in pediatric oncology patients with or without neutropenia [absolute neutrophil count (ANC) < 500/mm 3 ]. Methods: Baseline characteristics and infectious complications were compared between groups using univariate and multivariate analyses. Results: A total of 614 SQP were placed in 542 patients. Compared to nonneutropenic patients, those with neutropenia were more likely to have leukemia (n = 74, 94% vs n = 268, 50%), preoperative fever (n = 17, 22% vs n = 25, 5%), recent documented infection (n = 15, 19% vs n = 47, 9%), and were younger (81 vs 109 months) (p values < 0.01). After adjusting for fever and underlying-disease, there was a nonsignificant association between neutropenia and early postoperative infection (OR 2.42, 95% CI 0.82–7.18, p = 0.11). Only preoperative fever was a predictor of infection (OR 6.09, 95% CI 2.08–17.81, p = 0.001). Conclusion: SQP placement appears safe in most neutropenic patients. Type of study: Retrospective comparative study. Level of evidence: Level III.

Original languageEnglish (US)
Pages (from-to)145-149
Number of pages5
JournalJournal of pediatric surgery
Volume54
Issue number1
DOIs
StatePublished - Jan 1 2019

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Neutropenia
Pediatrics
Fever
Infection
Leukemia
Neutrophils
Multivariate Analysis
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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Neutropenia at the time of subcutaneous port insertion may not be a risk factor for early infectious complications in pediatric oncology patients. / VanHouwelingen, Lisa T.; Veras, Laura V.; Lu, Martin; Wynn, Lynn; Wu, John; Prajapati, Hasmukh; Gold, Robert; Murphy, Andrew J.; Fernandez-Pineda, Israel; Gosain, Ankush; Pui, Ching Hon; Davidoff, Andrew M.

In: Journal of pediatric surgery, Vol. 54, No. 1, 01.01.2019, p. 145-149.

Research output: Contribution to journalArticle

VanHouwelingen, Lisa T. ; Veras, Laura V. ; Lu, Martin ; Wynn, Lynn ; Wu, John ; Prajapati, Hasmukh ; Gold, Robert ; Murphy, Andrew J. ; Fernandez-Pineda, Israel ; Gosain, Ankush ; Pui, Ching Hon ; Davidoff, Andrew M. / Neutropenia at the time of subcutaneous port insertion may not be a risk factor for early infectious complications in pediatric oncology patients. In: Journal of pediatric surgery. 2019 ; Vol. 54, No. 1. pp. 145-149.
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abstract = "Background: The risk of infection associated with subcutaneous port (SQP) placement in patients with neutropenia remains unclear. We reviewed the rate of early infectious complications (< 30 days) following SQP placement in pediatric oncology patients with or without neutropenia [absolute neutrophil count (ANC) < 500/mm 3 ]. Methods: Baseline characteristics and infectious complications were compared between groups using univariate and multivariate analyses. Results: A total of 614 SQP were placed in 542 patients. Compared to nonneutropenic patients, those with neutropenia were more likely to have leukemia (n = 74, 94{\%} vs n = 268, 50{\%}), preoperative fever (n = 17, 22{\%} vs n = 25, 5{\%}), recent documented infection (n = 15, 19{\%} vs n = 47, 9{\%}), and were younger (81 vs 109 months) (p values < 0.01). After adjusting for fever and underlying-disease, there was a nonsignificant association between neutropenia and early postoperative infection (OR 2.42, 95{\%} CI 0.82–7.18, p = 0.11). Only preoperative fever was a predictor of infection (OR 6.09, 95{\%} CI 2.08–17.81, p = 0.001). Conclusion: SQP placement appears safe in most neutropenic patients. Type of study: Retrospective comparative study. Level of evidence: Level III.",
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AU - Veras, Laura V.

AU - Lu, Martin

AU - Wynn, Lynn

AU - Wu, John

AU - Prajapati, Hasmukh

AU - Gold, Robert

AU - Murphy, Andrew J.

AU - Fernandez-Pineda, Israel

AU - Gosain, Ankush

AU - Pui, Ching Hon

AU - Davidoff, Andrew M.

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