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Disorders of the Pleura |

Risk of Infectious Complications With Tunneled Pleural Catheter in Patients Undergoing Chemotherapy

Ashutosh Sachdeva*, MBBS; Janet Dawson, BSN; Hans Lee, MD; Rajiv Malhotra, DO; Ray Shepherd, MD
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VCU Health Sciences, Richmond, VA


Chest. 2012;142(4_MeetingAbstracts):522A. doi:10.1378/chest.1390598
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Abstract

SESSION TYPE: Pleural Disease Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Patients diagnosed with malignant pleural effusions (MPE) have a poor 6-month survival. Treatment options include repeated thoracentesis, pleurodesis, or tunneled pleural catheter (TPC) placement. TPCs are ideal for symptomatic patients with a poor functional status or non-expandable lung. Literature identifying risk of infectious complications in patients undergoing TPC and ongoing chemotherapy is limited. Chemotherapy may lower immune function and increase risk of infectious complications with TPC, but this has not been clearly studied.

METHODS: We identified patients undergoing TPC for MPE using retrospective electronic chart review. Inmates, patients with age > 89, and persons with non-malignant effusions were excluded. We compared the bivariable association between infectious complications and chemotherapy using Pearon's chi square test. We then constructed a multivariable model to control for potential confounding factors. The final model was adjusted for age, sex, BMI, renal failure and co-morbid conditions like diabetes.

RESULTS: We identified a total of 60 patients with TPC for MPE. Of these 27 (45%) received chemotherapy during the course of TPC drainage. A total of 5 (8%) infectious complications were identified. Of these, 4 were pleural space infections (3 non-chemotherpy group) and 1 identified as cellulitis (non-chemotherapy group). On unadjusted analysis the odds for developing infection in persons who underwent chemotherapy were, 0.53 (p = 0.48). On adjusted analysis using multivariable regression, the OR was 0.23 (p= 0.21) Our data analysis is limited by the retrospective nature of the study, small sample size, and low frequency of infectious complications. Despite our multivariable adjustments, we cannot exclude residual confounding by unmeasured factors.

CONCLUSIONS: Our data does not suggest increased risk of infections associated with placement of TPC in persons with ongoing chemotherapy.

CLINICAL IMPLICATIONS: Placement of TPC in persons undergoing chemotherapy does not seem to be associated with increased risk of infectious complications

DISCLOSURE: The following authors have nothing to disclose: Ashutosh Sachdeva, Janet Dawson, Hans Lee, Rajiv Malhotra, Ray Shepherd

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VCU Health Sciences, Richmond, VA

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