OBJECTIVE This systematic review and meta-analysis aimed to provide evidence-based guidance to better understand the risk of central line-associated bloodstream infection (CLABSI) in cancer patients who received totally implantable venous access ports (TIVAPs) compared with those who received external central venous catheters (CVCs). METHODS A systematic search of PubMed, Web of science, Embase, and the Cochrane Library was carried out from inception through Oct 2018, with no language restrictions. Trials examining the risk of CLABSI in cancer patients who received TIVAPs compared with those who received external CVCs were included. Two reviewers independently reviewed, extracted data, and assessed the risk of bias of each study. A random-effect model was used to estimate relative risks (RRs) with 95% CIs. RESULTS In all, 26 studies involving 27 cohorts and 5575 patients reporting the incidence of CLABSI in patients with TIVAPs compared with external CVCs were included. Pooled meta-analysis of these trials revealed that TIVAPs were associated with a significant lower risk of CLABSI than were external CVCs (relative risk [RR], 0.44; 95% confidence interval [CI], 0.31-0.62; P < 0.00001), which was confirmed by trial sequential analysis for the cumulative z curve entered the futility area. Subgroup analyses demonstrated that CLABSI reduction was greatest in adult patients (RR [95% CI], 0.35 [0.22-0.56]) compared with pediatric patients who received TIVAPs (RR [95% CI], 0.55 [0.38-0.79]). CONCLUSIONS TIVAP can significantly reduce the risk of CLABSI compared with external CVCs.

中文翻译：

---

癌症患者完全植入式静脉通路相关的血流感染风险：系统评价和荟萃分析。

目的 本系统评价和荟萃分析旨在提供循证指导，以更好地了解接受完全植入式静脉通路端口 (TIVAP) 的癌症患者与接受外部中心静脉通路的患者相比，中心导管相关血流感染 (CLABSI) 的风险。静脉导管 (CVC)。方法 系统检索 PubMed、Web of science、Embase 和 Cochrane 图书馆，从开始到 2018 年 10 月进行，没有语言限制。纳入了比较接受 TIVAP 与接受外部 CVC 的癌症患者发生 CLABSI 风险的试验。两名审查员独立审查、提取数据并评估每项研究的偏倚风险。使用随机效应模型估计 95% CI 的相对风险 (RR)。结果 总之，纳入 26 项研究，涉及 27 个队列和 5575 名患者，报告 TIVAP 患者与外部 CVC 相比 CLABSI 的发生率。这些试验的汇总荟萃分析显示，与外部 CVC 相比，TIVAP 与 CLABSI 风险显着降低相关（相对风险 [RR]，0.44；95% 置信区间 [CI]，0.31-0.62；P < 0.00001），这累积z曲线进入无效区的试验序贯分析证实。亚组分析表明，与接受 TIVAPs 的儿童患者（RR [95% CI]，0.55 [0.38-0.79]）相比，成人患者的 CLABSI 降低幅度最大（RR [95% CI]，0.35 [0.22-0.56]）。结论 与外部 CVC 相比，TIVAP 可以显着降低 CLABSI 的风险。