scholarly journals Risk Factors of Thromboembolic Disease in Men with Prostate Cancer: Report from a Hispanic Population

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5025-5025
Author(s):  
Rodrigo Luna-Santiago ◽  
Maria T Bourlon ◽  
Ariel Jasqui-Bucay ◽  
Alan Jasqui-Bucay ◽  
Oscar Manuel Fierro-Angulo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
Hip Fracture ◽  
Central Venous Catheter ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous ◽  
History Of

Abstract Introduction Prostate cancer is the most frequent malignant neoplasm diagnosed in men worldwide. Patients with prostate cancer have higher rates of thrombotic events when compared with other groups of cancer patients; that can be explained because of the presence of multiple risk factors such as age, histopathology, type of therapy, and associated comorbidities. The aim of this study was to determine the risk factors related to development of thrombosis in patients with prostate cancer in a tertiary care center. Methods Retrospective cohort study that included patients ≥18yo diagnosed with prostate cancer at our institution between 2014 and 2017. Univariate and multivariate analysis were performed including all previously described thrombosis risk factors in cancer patients. Results A total of 101 patients were included. Median age was 72 years (52-92). A total of 23 patients (22.8%) presented with a thrombotic event. Regarding baseline characteristics, patients with thrombosis were older (77 vs. 71 years; p=.015), had lower levels of HDL (40.4 vs. 48 mg/dL; p=.033), and a higher prevalence of primary hypertension (65.2% vs.34.6%; p=.009). In patients with thrombosis, 52.2% (n=12) were venous thrombosis and 47.8% (n=11) were arterial. The most common events were pulmonary thromboembolism (n=7; 58.3%) for venous thrombosis and acute coronary syndromes (n=6; 54.5%) for arterial events. In univariate analysis risk factors related to the development of thrombosis were: prostration > 3 days (p=.039), immobility (p=.023), central venous catheter (p=.004), congestive heart failure (p=.021), history of TE (p=.021), major surgery (p=.031) and hip fracture (p=.021). Table 1. On multivariate analysis factors that remained statistically significant were: central venous catheter OR 8.8 (CI 95% 2.2-35.7, p=.002), previous thrombosis OR 10.3 (CI 95% 1.5-72.8, p=.020), and hip fracture OR 8.5 (CI 95% 1.2-63.5,p=.037). Conclusions In conclusion, our study confirms findings from previous studies regarding factors that significantly predispose cancer patients to thrombosis development. Considering our population age, it is not surprising that risk factors in patients with prostate cancer were mainly related to the presence of other comorbiditiesparticularly cardiovascular and atherothrombotic disease. The main risk factor was history of previous thrombosis, suggesting that closer and prolonged anticoagulation therapy should be consider. Multicenter prospective studies most be urged in our population to asses and validate risk factors, and design prognostic scores that can help on determining which patients could be candidates to early intervention modifying preexisting factors and/or receiving prophylactic dose of anticoagulants. Disclosures No relevant conflicts of interest to declare.

scholarly journals Risk factors for the development of pneumonia in acute psychotropic drugs poisoning

2005 ◽  
Vol 62 (10) ◽  
pp. 715-723
Author(s):  
Slavica Vucinic
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Central Venous Catheter ◽  
Psychotropic Drugs ◽  
Univariate Analysis ◽  
Venous Catheter ◽  
Central Venous ◽  
Drug Poisoning ◽  
H2 Blockers ◽  
Underlying Diseases

Background/Aim. Pneumonia is the most frequent complication in acute psychotropic drugs poisoning, which results in substantial morbidity and mortality, but which also increases the costs of treatment. Risk factors for pneumonia are numerous: age, sex, place of the appearance of pneumonia, severity of underlying disease, airway instrumentation (intubation, reintubation, etc). The incidence of pneumonia varies in poisoning caused by the various groups of drugs. The aim of this study was to determine the incidence and risk factors for pneumonia in the patients with acute psychotropic drugs poisoning. Methods. A group of 782 patients, out of which 614 (78.5%) with psychotropic and 168 (21.5%) nonpsychotropic drug poisoning were analyzed prospectively during a two-year period. The diagnosis of pneumonia was made according to: clinical presentation, new and persistent pulmonary infiltrates on chest radiography, positive nonspecific parameters of inflammation, and the microbiological confirmation of causative microorganisms. To analyze predisposing risk factors for pneumonia, the following variables were recorded: sex, age, underlying diseases, endotracheal intubation, coma, severity of poisoning with different drugs, histamine H2 blockers, corticosteroids, mechanical ventilation, central venous catheter. The univariate analysis for pneumonia risk factors in all patients, and for each group separately was done. The multivariate analysis was performed using the logistic regression technique. Results. Pneumonia was found in 94 (12.02%) of the patients, 86 of which (91.5%) in psychotropic and 8 (8.5%) in nonpsychotropic drug poisoning. In the psychotropic drug group, pneumonia was the most frequent in antidepressant (47%), and the rarest in benzodiazepine poisoning (3.8%). A statistically significant incidence of pneumonia was found in the patients with acute antidpressant poisoning (p < 0.001). Univariate analysis showed statistical significance for the following parameters: sex (p < 0.05), chronic alcohol intake (p < 0.05), underlying diseases (p < 0.01), central venous catheter (p < 0.05) vasopressors (p < 0.05), coma (p < 0.001), H2 blockers (p < 0.001) and corticosteroids (p < 0.001). The multivariate analysis retained endotracheal intubation and antidepressant drug poisoning as an independent risk factor for pneumonia. Conclusion. Using univariate and multivariate analysis, risk factors for developing pneumonia were disclosed. Some of these factors may be modified by simple medical procedures, thus the incidence and mortality rate of pneumonia in drug poisoning might be substantially reduced.

Lessons from French national guidelines on the treatment of venous thrombosis and central venous catheter thrombosis in cancer patients

2010 ◽  
Vol 125 ◽  
pp. S108-S116 ◽  
Author(s):  
Dominique Farge ◽  
Cecile Durant ◽  
Stéphane Villiers ◽  
Anne Long ◽  
Alfred Mahr ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Venous Catheter ◽  
National Guidelines ◽  
Central Venous

Analysis of Independent Risk Factors for Death Among Pediatric Patients With Candidemia and a Central Venous Catheter in Place

2007 ◽  
Vol 28 (7) ◽  
pp. 799-804 ◽  
Author(s):  
Alessandro C. Pasqualotto ◽  
Anaelena B. de Moraes ◽  
Roselaine R. Zanini ◽  
Luiz Carlos Severo
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Central Venous Catheter ◽  
Pediatric Patients ◽  
Medical Center ◽  
Severity Of Illness ◽  
Early Death ◽  
Venous Catheter ◽  
Central Venous ◽  
Late Death

Objective.To use multivariate analysis to determine risk factors for death among pediatric patients with candidemia and a central venous catheter in place.Design.Retrospective cohort study conducted at Santa Casa Complexo Hospitalar, a 1,200-bed teaching hospital in southern Brazil.Methods.All cases of candidemia in pediatric patients (age, ≤ 13 years) at our medical center over a 9-year period were reviewed. A diagnosis of sepsis was required for inclusion in the study. Severity of illness was confirmed by the presence of hypotension requiring inotropes and according to the following scores: the Pediatric Risk of Mortality (PRISM) II score, the PRISM III score, and the Pediatric Logistic Organic Dysfunction score. The following 2 outcomes were evaluated: early death, defined as death occurring within 7 days after candidemia was diagnosed, and late death, defined as death 8-30 days after candidemia was diagnosed.Results.A total of 61 patients were included in the study, including 14 neonates. Most (63.9%) of these patients were girls, and the median age was 0.3 years. A total of 80.3% of candidemia cases were due to species other than Candida albicans, primarily Candida parapsilosis (32.8% of cases) and Candida tropicalis (24.6% of cases). Using multivariate analysis, we demonstrated that failure to remove the central venous catheter was an independent risk factor for early death among pediatric patients with candidemia. However, patients whose catheters were retained were sicker than patients whose catheters were removed, and catheter removal had no impact on late death. Instead, severity of illness determined using the PRISM III score was also an independent predictor of late death.Conclusions.Results from this study suggest that systematic removal of catheters from pediatric patients with candidemia does not reduce the occurrence of late death.

scholarly journals Treatment of central venous catheter-associated deep venous thrombosis in cancer patients with rivaroxaban

2016 ◽  
Vol 92 (1) ◽  
pp. E9-E10 ◽  
Author(s):  
Eva S. Laube ◽  
Simon Mantha ◽  
Patrick Samedy ◽  
Jonathan Wills ◽  
Stephen Harnicar ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous

scholarly journals Incidence, risk factors, and outcomes of central venous catheter-related thromboembolism in breast cancer patients: the CAVECCAS study

2017 ◽  
Vol 6 (11) ◽  
pp. 2732-2744 ◽  
Author(s):  
Philippe Debourdeau ◽  
Marc Espié ◽  
Sylvie Chevret ◽  
Joseph Gligorov ◽  
Antoine Elias ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Breast Cancer Patients ◽  
Central Venous ◽  
Incidence Risk

Inefficiency in 6-Set Requests for Blood Culture Analysis of Cancer Patients with the Central Venous Catheter

2013 ◽  
Vol 3 (3) ◽  
pp. 155
Author(s):  
Dong-Hyun Lee ◽  
Eun-ha Koh ◽  
Sunjoo Kim ◽  
In-Gyu Bae ◽  
Hoon-gu Kim ◽  
...  
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous

Risk factor identification and predictive models for central line requirements for patients on vasopressors

2021 ◽  
pp. 0310057X2110242
Author(s):  
Adrian D Haimovich ◽  
Ruoyi Jiang ◽  
Richard A Taylor ◽  
Justin B Belsky
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Single Agent ◽  
Composite Endpoint ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Central Venous

Vasopressors are ubiquitous in intensive care units. While central venous catheters are the preferred route of infusion, recent evidence suggests peripheral administration may be safe for short, single-agent courses. Here, we identify risk factors and develop a predictive model for patient central venous catheter requirement using the Medical Information Mart for Intensive Care, a single-centre dataset of patients admitted to an intensive care unit between 2008 and 2019. Using prior literature, a composite endpoint of prolonged single-agent courses (>24 hours) or multi-agent courses of any duration was used to identify likely central venous catheter requirement. From a cohort of 69,619 intensive care unit stays, there were 17,053 vasopressor courses involving one or more vasopressors that met study inclusion criteria. In total, 3807 (22.3%) vasopressor courses involved a single vasopressor for less than six hours, 7952 (46.6%) courses for less than 24 hours and 5757 (33.8%) involved multiple vasopressors of any duration. Of these, 3047 (80.0%) less than six-hour and 6423 (80.8%) less than 24-hour single vasopressor courses used a central venous catheter. Logistic regression models identified associations between the composite endpoint and intubation (odds ratio (OR) 2.36, 95% confidence intervals (CI) 2.16 to 2.58), cardiac diagnosis (OR 0.72, CI 0.65 to 0.80), renal impairment (OR 1.61, CI 1.50 to 1.74), older age (OR 1.002, Cl 1.000 to 1.005) and vital signs in the hour before initiation (heart rate, OR 1.006, CI 1.003 to 1.009; oxygen saturation, OR 0.996, CI 0.993 to 0.999). A logistic regression model predicting the composite endpoint had an area under the receiver operating characteristic curve (standard deviation) of 0.747 (0.013) and an accuracy of 0.691 (0.012). This retrospective study reveals a high prevalence of short vasopressor courses in intensive care unit settings, a majority of which were administered using central venous catheters. We identify several important risk factors that may help guide clinicians deciding between peripheral and central venous catheter administration, and present a predictive model that may inform future prospective trials.

Unfractionated Heparin (UFH) For Prevention of Central Venous Catheter Thrombotic Complications in Children: A systematic review and meta-analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Marwa W Nasef ◽  
Maha M El-gaffary ◽  
Mervet G Mansour ◽  
Esraa S Abd El Aty
Keyword(s):  
Central Venous Catheter ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Unfractionated Heparin ◽  
Meta Analysis ◽  
Venous Catheter ◽  
Controlled Trials ◽  
Central Venous ◽  
Thrombotic Occlusion ◽  
Thrombotic Complications

Abstract Objective To determine the efficacy of unfractionated heparin in reducing central venous catheter-related deep venous thrombosis and/or catheter thrombotic occlusion in children by systematically searching the literature and conducting a meta-analysis study. Methods Four electronic databases (PubMed, Google Scholar, Elsevier’s thrombosis journal, and the Cochrane Central Register for Controlled Trials) were searched for journal peer-reviewed articles published in the period from Jan 2000 to Dec 2018. The search criteria included observational studies, and randomized controlled trials on patients aged 0–18 years with central venous catheters (CVC), which compare between the effect of UFH (flushes, lock solutions, continuous infusion, and heparin bonded catheter) and no prophylaxis (Normal saline flush or no treatment) for the prevention of CVC thrombotic complications (CVC-related deep venous thrombosis (DVT) and/or catheter thrombotic occlusion). Two authors independently reviewed and identified the eligible studies, which were assessed for study methodology including bias, and extraction of unadjusted data whenever available. To pool data from eligible studies, the meta-analysis was performed on RevMan version 5.3. Odds ratios were generated with the corresponding 95% CI through the random-effect model. Results Of the 413 articles identified, only eight studies were eligible with 1380 patients. Our results revealed that UFH was significantly superior on control group in reducing thrombotic occlusion and/or CVC-related DVT (odds ratio 0.39, 95% CI: 0.19:0.8) (p 0.01). Conclusion The published data support the hypothesis that using UFH as a thromboprophylaxis may significantly reduce catheter thrombotic complication in pediatric patients with CVC.

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