Incidence and Potential Risk Factors of Catheter Associated Thrombosis in Solid Tumors

Abstract PurposeCentral venous catheters (CVCs) have become common practice in oncology. Besides their benefits, as an invasive procedure, several complications are associated with them. Catheter associated thrombosis (CAT) is one of the most relevant due to their impact in quality of life and mortality, but the prothrombotic risk factors implied have been poorly assessed. The aim of the study is to evaluate the incidence of upper extremity deep vein thrombosis (UEDVT) associated to catheter use in patients with solid tumors. Secondary endpoints are to describe the population using CVCs and to evaluate potential risk factors of CAT. MethodsPatients diagnosed of solid tumors assisted at a tertiary level hospital between 2016 and 2019, and using CVCs were included.Results455 patients were enrolled. The incidence of CAT was 5.49% (25) in the whole population. 5.05% (23) was associated with PICC while 0.44% (2) was due to PORT use. Among the factors included in the univariate and multivariate regression models, age ≥50 years and PORT use were identified as protective factors related to the development of CAT.ConclusionCVCs remains a safe approach for the delivering of treatments in patients with solid tumors. Age ≤50 and use of PICC are risk factors for developing CAT. Larger prospective studies are needed to identify additional risk factors of CAT.

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The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04417-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xinyan Yu ◽

Yingying Wu ◽

Rende Ning

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Deep Vein Thrombosis ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Lower Limb ◽

Vein Thrombosis ◽

Duration Of Surgery ◽

Potential Risk Factors ◽

Deep Vein

Abstract Background Deep vein thrombosis (DVT) of lower limb is one of the common complications after total hip arthroplasty(THA), we aimed to evaluate the potential risk factors of DVT of lower limb in patients with THA, to provide insights into the management of THA. Methods Patients who underwent THA in our hospital from January 1, 2017 to November 30, 2020 were included. The personal characteristics and clinical data of DVT and no-DVT patients were compared and analyzed. Logistic regression analyses were perfomed to identify the potential risk factors of DVT in patients with THA. Results A total of 182 THA patients were included, the incidence of DVT of lower limb in patients with THA was 19.78 %. There were significant differences in the age, BMI, diabetes, number of replacement, duration of surgery, type of prosthesis and duration of days in bed between DVT and no-DVT patients(all P < 0.05). And there were no significant differences in the gender, hypertension, hyperlipidemia, preoperative D-dimer, type of anesthesia and anticoagulant drugs use(all P > 0.05). Logistic regression analysis indicated that age > 70y(OR4.406, 95 %CI1.744 ~ 6.134), BMI ≥ 28(OR2.275, 95 %CI1.181 ~ 4.531), diabetes(OR3.949, 95 %CI1.284 ~ 5.279), bilateral joint replacements(OR2.272, 95 %CI1.402 ~ 4.423), duration of surgery ≥ 120 min(OR3.081, 95 %CI1.293 ~ 5.308), cemented prosthesis(OR2.435, 95 %CI1.104 ~ 4.315), and duration of days in bed > 3 days(OR1.566, 95 %CI1.182 ~ 1.994) were the risk factors of DVT of lower limb in patients with THA. Conclusions DVT in the lower limb after THA is common, and its onset is affected by many factors. In clinical work, attention should be paid to identify the risk factors for DVT and targeted interventions are highlighted to prevent the postoperative DVT.

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Thrombosis in Hodgkin Lymphoma Patients: Incidence, Time Points, Risk Factors and Impact of Stage and Treatment

Blood ◽

10.1182/blood.v128.22.4151.4151 ◽

2016 ◽

Vol 128 (22) ◽

pp. 4151-4151

Author(s):

Sven Borchmann ◽

Ida Hude ◽

Horst Müller ◽

Heinz Haverkamp ◽

Carolin Bürkle ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Early Stage ◽

Significant Risk ◽

Incidence Rates ◽

Comprehensive Analysis ◽

Advanced Stage ◽

Vein Thrombosis ◽

Potential Risk Factors ◽

Prophylactic Anticoagulation

Abstract Thrombotic events are regularly observed in patients receiving treatment for Hodgkin Lymphoma (HL). However, sound data on incidence and risk factors are not known. The aim of the present study was thus to provide a comprehensive analysis of thrombotic events after multimodality treatment for HL. A total of 5,773 patients ≤ 60 years treated within the German Hodgkin Study Group (GHSG) trials HD13-15 between January 2003 and December 2009 were included in this analysis. All reported venous and arterial thrombotic events occurring within 1 year after trial enrollment were evaluated and detailed information on patient characteristics, localizations, time of occurrence and risk factors were collected. We excluded thromboses of superficial veins and thrombophlebitis. Descriptive statistics and logistic regression were used for statistical analysis. A total of 193 thrombotic events occurred for an incidence of 3.3%; there were 11 events in early-favorable, 27 in early-unfavorable and 155 in advanced stage HL, resulting in incidence rates of 0.7%, 1.3% and 7.3%, respectively. The incidence in advanced stage HL was significantly higher than in early stage HL (p<0.001); 175 events were venous and 18 arterial. The most common venous events consisted of arm vein thrombosis in 49.1% (n=86), DVT in 29.1% (n=51), PE in 13.1% (n=23) and sinus vein thrombosis in 1.7% (n=3) of cases. The most common arterial events were MI in 55.6% (n=10), lower extremities arterial thromboembolism in 22.2% (n=4) and CVI in 16.7% (n=3) of cases. 30.6% (n=59) of events were associated with intravenous catheters, 8.8% (n=17) were likely due to tumor compression and 1.0% (n=2) occurred despite prophylactic anticoagulation. We found that 2.6% (n=5), 77.2% (n=149) and 20.2% (n=39) of cases occurred before, during and after chemotherapy respectively. In advanced HL patients treated with 8 x BEACOPPesc, 6 x BEACOPPesc or 8 x BEACOPP-14 , the incidence rates were 6.2% (n=44), 5.5% (n=39) and 10.1% (n=72) respectively. The incidence in patients treated with BEACOPP-14 was significantly higher than in patients treated with the other two regimens (p<0.01). Opposed to rather evenly distributed events during chemotherapy with BEACOPPesc, thromboses during treatment with BEACOPP-14 occurred more frequently at the beginning of chemotherapy. We then analyzed potential risk factors in advanced stage patients using logistic regression analysis, adjusting for treatment in order to identify a high-risk group for developing a thrombotic event. The well-established Khorana score was not associated with a higher risk of thrombosis (odds ratio (OR) per unit [95% confidence interval]: 0.91 [0.76-1.1], p=0.33). Additionally, we screened 21 potential risk factors, including the thrombocyte-to-lymphocyte ratio. Only age (OR per year: 1.02 [1.01-1.03], p=0.01) and smoking (OR: 1.61 [1.07-2.43], p=0.02) emerged as significant risk factors. None of the other following potential risk factors was prognostic: thrombocyte-to-lymphocyte ratio, thrombocytes, leukocytes, lymphocytes, hemoglobin, albumin, WHO activity index, erythropoietin treatment, sex, body mass index, B-symptoms, erythrocyte sedimentation rate, extranodal disease, large mediastinal mass, more than 2 affected areas or Ann Arbor stage (all p≥0.10). Yet, when only including venous events, which are potentially preventable by prophylactic anticoagulation, neither age nor smoking were significant risk factors anymore (p≥0.10). This study is the largest and most comprehensive analysis of thrombotic events in HL patients to date. Compared to both, early-favorable and early-unfavorable HL, advanced stage patients are at higher risk for thrombotic events. The most widely used Khorana score estimating thrombosis risk in cancer outpatients was not prognostic in the HL population investigated here. This is unsurprising considering the young age of the patient population investigated. Other risk factors were also not prognostic. This data does not imply a need for prophylactic anti-coagulation in outpatients treated for early-stage HL. In advanced-stage HL patients, routine prophylactic anticoagulation is not warranted. However, individual patients with additional risk factors that could not be evaluated such as history of thrombosis or reduced mobility might still benefit from prophylactic treatment. Disclosures Engert: Takeda, BMS: Consultancy, Honoraria, Research Funding.

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Deep vein thrombosis and pulmonary embolism in pediatric COVID-19

10.22541/au.163265310.03774825/v1 ◽

2021 ◽

Author(s):

Loukia Ioannidou ◽

Athina Dettoraki ◽

Maria Noni ◽

Dimitra Koukou ◽

Aiketarini Michalopoulou ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Laboratory Tests ◽

Rt Pcr ◽

Aromatase Inhibitor Therapy ◽

Vein Thrombosis ◽

Prothrombotic Risk Factors ◽

Thrombotic Complications ◽

Deep Vein

Thrombotic complications of SARS-CoV-2 have been increasingly recognized as an important component of COVID-19 in adults; however, they have been less evident in children. We report a case of a teenager with positive SARS‐CoV‐2 RT–PCR and underlying prothrombotic risk factors, including aromatase inhibitor therapy, who developed deep vein thrombosis resulting in pulmonary embolism. Laboratory tests revealed deranged coagulation parameters (high D-dimers and Factor VIII and low antithrombin). The patient required intensive care and was managed with anticoagulants, dexamethasone and antithrombin concentrate. Clinical condition and hemostatic profile gradually improved. A review of the available literature for similar cases is presented.

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Studi Residu Antibiotika dan Kualitas Mikrobiologi Telur Ayam Konsumsi yang Beredar di Kota Administrasi Jakarta Timur

Jurnal Ilmu Produksi dan Teknologi Hasil Peternakan ◽

10.29244/jipthp.8.3.151-159 ◽

2020 ◽

Vol 8 (3) ◽

pp. 151-159

Author(s):

Anton ◽

E. Taufik ◽

Z. Wulandari

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Egg Production ◽

Descriptive Analysis ◽

Microbiological Quality ◽

Logistic Regression Models ◽

Traditional Markets ◽

Potential Risk Factors ◽

Chicken Eggs

Chicken eggs are fairly high in nutritional content, especially in proteins. Usually, antibiotics are used indisease prevention and treatment program at the layer chicken farms. The use of antibiotics are still notaccording to the direction of use. Egg production is also susceptible to bacterial contamination. Therefore,the objective of this study was to analyze the presence of kanamycin residue, the microbiological quality,and to evaluate potential risk factors associated with the microbiological quality of chicken eggs in theadministration city of East Jakarta. The samples were 100 eggs taken from 21 traditional markets and4 supermarkets in the administration city of East Jakarta. Kanamycin residue tested using bioassaymethod based on SNI 7424: 2008 and the microbiological quality method used based on SNI 3926: 2008.Data were analyzed using descriptive analysis univariate Chi-Square test to determine the effect ofpotential risk factors on the quality of microbiological quality and logistic regression models to analyzethe effect of potential risk factors without looking at the interaction of other factors. The results showedthat kanamycin residues were detected in 26.19% of eggs from traditional markets and 31.25% eggsfrom supermarkets in the administration city of East Jakarta. The median value of TPC, coliform andE.coli were 0.7 log cfu/g, 1.5 MPN/g, and 1.5 MPN/g, respectively, whilst Salmonella sp test was negative.It can be concluded that kanamycin residues still found in the markets and the microbiological qualitywere below the maximum contamination limit based on SNI 3926:2008 and egg cleanness was a riskfactor for coliform contamination.

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Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645677 ◽

1990 ◽

Vol 63 (01) ◽

pp. 013-015 ◽

Cited By ~ 15

Author(s):

E J Johnson ◽

C R M Prentice ◽

L A Parapia

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Potential Risk ◽

Antithrombin Iii ◽

Arterial Disease ◽

Coagulation System ◽

Early Age ◽

Arterial Thromboembolism ◽

Potential Risk Factors ◽

Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

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