Correlates of Implantable Port Placement in Patients Receiving Electroconvulsive Therapy

OBJECTIVES: Establishing intravenous access before each electroconvulsive therapy (ECT) session can be challenging, contributing to delays, sedation-related interventions, and treatment discontinuation. Implantable ports may reduce these barriers, yet factors associated with port placement are not well understood. This study examined correlates of port placement among patients receiving ECT. METHODS: We conducted a retrospective cohort study of patients who received ECT at a single academic center between 2017 and 2025. The primary outcome was receipt of an implantable port for facilitation of ECT. Variables examined included age, sex, race, number of ECT sessions, history of catatonia, and history of autism spectrum disorder, using univariate statistical tests. RESULTS: A total of 1057 patients were included; 27 (2.6%) received a port. Higher ECT session count was associated with port placement (P<0.001). The number of ECT sessions before port placement ranged from 0 to 135, with a median value of 11. The history of autism was more common among port recipients (6.6% in nonport patients vs. 22.2% with port, P=0.002). Female sex was associated with port placement (56.4% vs. 77.8%, P=0.027). CONCLUSIONS: Higher treatment burden, history of autism, and female sex were associated with increased likelihood of port placement among patients receiving ECT. Recognition of these factors may support earlier consideration of port placement in patients anticipated to require prolonged or complex ECT courses.