The risk factors of delayed complications after central venous port placement

Background and aim: Advances in chemotherapy and the aging population have increased central venous ports (CVPs) usage for parenteral nutrition or chemotherapy. However, delayed complications (DCs) often burden patients and healthcare resources by interrupting treatment. This study aimed to identify independent risk factors for DCs necessitating intervention or removal. Methods: We retrospectively analyzed 239 consecutive patients who underwent initial CVP placement between January 2013 and December 2024. DCs were defined as port-related complications occurring > 30 days after placement that required intervention or prolonged medical treatment. Patients were classified into DC group and a non-DC group. Potential risk factors for DCs and overall survival (OS) were evaluated using multivariate analysis. Results: DCs occurred in 32 patients (13.4%). The most frequent complication was catheter-related bloodstream infection (18 patients, 7.5%), followed by device breakage (seven patients, 2.9%) and other complications (seven patients, 2.9%). CVP removal was required in 30 patients (93.8%) with DCs. Multivariate analysis identified three independent predictors of DCs: history of diabetes mellitus (DM), history of infection, and higher cholinesterase levels. OS was significantly longer in the DC group than in the nDC group. Multivariate analysis of OS revealed that factors associated with DC risk, including a history of infection and higher cholinesterase levels, were also favorable prognostic factors. Conclusions: A history of DM, history of infection, and higher cholinesterase levels are strong independent predictors of DCs following CVP placement. Careful pre-procedural assessment, optimal infection control, and vigilant post-placement surveillance are essential, particularly in patients with those risk factors.