OUTCOMES OF TOTALLY IMPLANTABLE VENOUS ACCESS PORT IMPLANTATION IN OLDER ADULTS: AGE IS NOT THE KEY DETERMINANT
TL;DR
The findings support the safe use of ports in older patients and emphasize the importance of technical optimization and device selection, after advanced age was not associated with adverse outcomes following implantation.
Abstract
Introduction: Totally implantable venous access ports are used in oncologic care, yet the impact of age on outcomes remains controversial. This study aimed to evaluate whether geriatric status is associated with complications, catheter malposition, or port revision, and to identify independent predictors of adverse outcomes. Materials and Method: This cohort study included 1,215 patients who underwent totally implantable venous access port implantation at a single tertiary center between June 2022 and December 2025. All procedures were performed by a single thoracic surgeon. Patients were categorized as nongeriatric (<65 years) and geriatric (≥65 years), with analysis for those aged ≥75 years. Primary outcomes were any complication and port revision, and the secondary outcome was catheter malposition. Univariable and multivariable logistic regression analyses were performed. Results: Of the 1,215 patients, 487 (40.1%) were geriatric. Geriatric patients had lower rates of complications (4.9% vs 7.7%), malposition (0.4% vs 1.1%), and revision (2.9% vs 4.5%), with no significant differences. Geriatric status was not an independent predictor of any outcome. Prior chemotherapy and port structural parameters independently increased the risk of complications, while port size parameters remained the strongest predictors of revision, with port thickness associated with a 2.5-fold higher risk. Subclavian access and multiple insertion attempts were associated with malposition in univariable analyses. Conclusion: Advanced age was not associated with adverse outcomes following implantation. Procedural and device-related factors, rather than chronological age, were the primary determinants of complications and revision. These findings support the safe use of ports in older patients and emphasize the importance of technical optimization and device selection. Keywords: Vascular Access Devices; Aged; Catheterization, Central Venous; Postoperative Complications; Risk Factors.