Use of subcutaneous catheters (SC) in the domiciliary palliative healthcare programme at Fundación Santa Fe de Bogotá.

Uso del catéter subcutáneo (CS) en el programa de cuidado paliativo domiciliario de la Fundación Santa Fe de Bogotá.

Introduction: Subcutaneous catheters (SC) represent a useful tool for facilitating the domiciliary management of patients suffering from oncological or chronic terminal disease. Materials and methods: The present study reflects the results of an ambidirectional registry which began to collect information about the domiciliary use of SCs in a population of patients who were in a palliative care (PC) program from July 2009 to December 2010. Included variables evaluated the demographic characteristics of the population, the indications and usage profile of SC and their related complications. Each event (placement of a SC) was independently recorded (even if it ocurred in the same patient). Results: A total of 140 interventions were made in 66 patients having a mean age of 64 years (+/-16). They were equally distributed according to gender; 71% of the subjects had a <50% Karnofsky index and only 16% were receiving active oncological treatment, this being more frequent in men (p >< 0.05) and those having less functional compromise (p < 0.05). The most frequent oncological diagnoses were gastrointestinal tumors (28%/42%), genitourinary tract tumors (12%/18%) and primary tumors of the head and neck (5%/8%). The main indication for placing a SC was the administration of opioid and non-opioid analgesics (87%), followed by the management of nausea and vomiting (32%). Mean time for using a SC was 15.8 days (+/-11), the most used site was the infraclavicular region (64%) and the main motive for installing them was to facilitate administering drugs (95%). The therapeutic objective was achieved in 92% of the cases; the end was not achieved in the remaining population due to the procedure being used for controlling tumoral dyspnea (4/5 cases of lung cancer). The complication rate was 35% amongst 128 evaluable cases. Adverse events were associated with the concomitant administration of chemotherapy and/or radiotherapy (p = 0.03), with the ongoing infusion of opioids (p = 0.03), when the main motive was analgesia (p = 0.006), and when SC lasted less than 15 days (p = 0.003). Conclusion: SC is an integral management strategy for patients who are receiving domiciliary PC, having a high benefit-to-risk ratio.