Incidence and risk factors of subclinical umbilical catheter-related thrombosis in neonates

e14031 Background: The central venous catheter brings convenience for drug delivery and improves comfort for cancer patients, it also causes serious complications. The most common one is catheter-related thrombosis (CRT). This study aimed to evaluate the incidence and risk factors of CRT in cancer patients, and to develop an effective prediction model for CRT in cancer patients. Methods: The development of our prediction model was based on the data of a retrospective cohort (n = 3131) from National Cancer Center. The validation of our prediction model was done in a prospective cohort from National Cancer Center (n = 685) and a retrospective cohort from Hunan Cancer Hospital (n = 61). The predictive accuracy and the discriminative ability were determined by the receiver operating characteristic curves and calibration plots. Results: Multivariate analysis demonstrated that sex, cancer type, catheter type, position of the catheter tip, chemotherapy status, and antiplatelet/anticoagulation status at baseline were independent risk factors for CRT. The area under receiver operating characteristic (ROC) curve of our prediction model was 0.741 (CI: 0.715-0.766) in the primary cohort; 0.754 (CI: 0.704-0.803) and 0.658 (CI: 0.470-0.845) in validation cohorts respectively. Good calibration and clinical impact were also shown in primary and validation cohorts. The high-risk group had a higher incidence of CRTs than the low-risk group in the primary cohort and two validation cohort (p < 0.001). Conclusions: Our model is a novel prediction tool for CRT risk which helps to assigning cancer patients into high-risk or low-risk group accurately. Our model will be valuable for clinicians in decision making of thromboprophylaxis.

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Risk Factors for Catheter-Related Thrombosis in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation

Medicina ◽

10.3390/medicina57101020 ◽

2021 ◽

Vol 57 (10) ◽

pp. 1020

Author(s):

Anna Hoppe ◽

Joanna Rupa-Matysek ◽

Bartosz Małecki ◽

Dominik Dytfeld ◽

Krzysztof Hoppe ◽

...

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Autologous Stem Cell Transplantation ◽

Hematopoietic Stem ◽

Gastrointestinal Complications ◽

Comorbidity Index ◽

Catheter Related Thrombosis

Background and Objectives: Cancer associated thrombosis (CAT) is a common complication of neoplasms. Multiple myeloma (MM) carries one of the highest risks of CAT, especially in the early phases of treatment. Autologous stem cell transplantation (ASCT) as the standard of care in transplant-eligible patients with MM carries a risk of catheter-related thrombosis (CRT). The aim of this study was identification of the risk factors of CRT in MM patients undergoing ASCT in 2009–2019. Materials and Methods: We retrospectively analyzed patients with MM undergoing ASCT. Each patient had central venous catheter (CVC) insertion before the procedure. The clinical symptoms of CRT (edema, redness, pain in the CVC insertion area) were confirmed with Doppler ultrasound examination. We examined the impacts of four groups of factors on CRT development: (1) patient-related: age, gender, Body Mass Index (BMI), obesity, Charlson comorbidity index, hematopoietic stem cell transplantation comorbidity index, renal insufficiency, and previous thrombotic history; (2) disease-related: monoclonal protein type, stage of the disease according to Salmon–Durie and International Staging System, number of prior therapy lines, and MM response before ASCT; (3) treatment-related: melphalan dose, transplant-related complications, and duration of post-ASCT neutropenia; (4) CVC-related: location, time from placement to removal. Results: Symptomatic CRT was present in 2.5% (7/276) of patients. Univariate analysis showed an increased risk of CRT in patients with a catheter-related infection (OR 2.4, 95% CI; 1.109–5.19, p = 0.026), previous thrombotic episode (OR 2.49, 95% CI; 1.15–5.39, p = 0.021), previous thrombotic episode on initial myeloma treatment (OR 2.75, 95% CI; 1.15–6.53, p = 0.022), and gastrointestinal complications of ASCT such as vomiting and diarrhea (OR 3.87, 95% CI; 1.57–9.53, p = 0.003). In multivariate analysis, noninfectious complications were associated with higher CRT incidence (OR 2.75, 95% CI; 1.10–6.19, p = 0.031). Conclusions: The incidence of symptomatic CRT in ASCT in MM was relatively low. Previous thrombotic events, especially during the induction of myeloma treatment, increased CRT risk during ASCT. Dehydration following gastrointestinal complications may predispose to higher CRT incidence.

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Prevalence, risk factors, treatment and outcomes of catheter-related thrombosis in patients with malignancies.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e17517 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e17517-e17517

Author(s):

Julie Cote ◽

Olivier Dumas ◽

Christine Demers ◽

Julie Lemieux

Keyword(s):

Risk Factors ◽

Previous History ◽

Venous Catheter ◽

Hematologic Malignancies ◽

Quebec City ◽

Therapeutic Approaches ◽

Incidence Risk ◽

History Of ◽

Mean Time ◽

Catheter Related Thrombosis

e17517 Background: Tunnelled catheters (Leonard, BARD) and peripherally inserted central catheters (Piccline, BARD) are used for intravenous therapies in patients with malignancies. Thrombosis is a well known complication, but risk factors are not clearly established. The objective the incidence, risk factors, therapeutic approaches and complications of catheter-related thrombosis among patients with malignancies. Methods: Medical charts of patients with malignancies and Leonard or Piccline inserted, from August 2002 to December 2006 at Hôpital de l’Enfant-Jésus (Québec City, Canada), were retrospectively reviewed. Results: A total of 618 catheters were inserted in 361 patients. Eighty-six percent of the catheters were placed in patients with hematologic malignancies and most were Piccline (70%). Sixty-one thromboses were identified (incidence of 10%). Fourteen percent of the patients had more than one episode of catheter-related thrombosis. The majority of thromboses was related to a Piccline (93%) and occurred at a mean time of 34 days after the insertion. At the time of thrombosis, the mean platelet count was 169 x 109/L. Previous history of a catheter-related thrombosis (OR = 4.30 (1.48-12.50); p = 0.0075) as well as lymphoma (OR = 3.29 (1.22-8.87); p = 0.0185) were associated with superficial thromboses. The Piccline was associated with both types of thromboses (OR = 5.78 (1.69-19.74); p = 0.0051), especially with superficial thromboses. Most of the catheters (88%) were removed once a thrombosis was identified. The management of anticoagulation varied considerably. No complication associated with thromboses was reported. Conclusions: The incidence of central venous catheter-related thrombosis was 10%. The thrombosis occurred on average 34 days after the insertion. The Piccline was associated with all types of thromboses, especially the superficial ones. A previous history of catheter-related thrombosis and lymphoma were risk factors for superficial thromboses. Further studies are necessary to better define characteristics and optimal management of central catheter-related thrombosis.

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Incidence, Risk Factors, and Outcomes of Catheter-Related Thrombosis in Adult Patients With Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.5600 ◽

2006 ◽

Vol 24 (9) ◽

pp. 1404-1408 ◽

Cited By ~ 189

Author(s):

Agnes Y.Y. Lee ◽

Mark N. Levine ◽

Gregory Butler ◽

Carolyn Webb ◽

Lorrie Costantini ◽

...

Keyword(s):

Risk Factors ◽

Life Span ◽

Baseline Risk ◽

Patients With Cancer ◽

Postphlebitic Syndrome ◽

Symptomatic Pulmonary Embolism ◽

Incidence Risk ◽

A Prospective Study ◽

Catheter Related Thrombosis

Purpose Thrombosis of long-term central venous catheters (CVC) is a serious complication that causes morbidity and interrupts the infusion of chemotherapy, intravenous medication, and blood products. We performed a prospective study to examine the incidence, risk factors, and long-term complications of symptomatic catheter-related thrombosis (CRT) in adults with cancer. Patients and Methods Consecutive patients with cancer, undergoing insertion of a CVC, were enrolled and prospectively followed while their catheter remained in place plus 4 subsequent weeks or a maximum of 52 weeks, whichever came first. Patients with symptomatic CRT were followed for an additional 52 weeks from the date of CRT diagnosis. The end points were symptomatic CRT, symptomatic pulmonary embolism (PE), postphlebitic syndrome, and catheter life span. Results Over 76,713 patient-days of follow-up, 19 of 444 patients (4.3%) had symptomatic CRT in 19 of 500 catheters (0.3 per 1,000 catheter-days). The median time to CRT was 30 days and the median catheter life span was 88 days. Significant baseline risk factors for CRT were: more than one insertion attempt (odds ratio [OR] = 5.5; 95% CI, 1.2 to 24.6; P = .03); ovarian cancer (OR = 4.8; 95% CI, 1.5 to 15.1; P = .01); and previous CVC insertion (OR = 3.8; 95% CI, 1.4 to 10.4; P = .01). Nine of the 19 CRT patients were treated with anticoagulants alone, eight patients were treated with anticoagulants and catheter removal, while two patients did not receive anticoagulation. None had recurrent CRT or symptomatic PE. Postphlebitic symptoms were infrequent. Conclusion In adults with cancer, the incidence of symptomatic CRT is low and long-term complications are uncommon.

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