Junren Kang1, Wenyan Sun1, Hailong Li1, Enling Ma1, Kai Wang1, Wei Chen1. 1. Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China.
Abstract
PURPOSE: To identify clinical incidence, risk factors and treatment of peripherally inserted central venous catheters (PICCs)-related upper extremity venous thrombosis (UEVT) in breast cancer patients undergoing chemotherapy. METHODS: We performed a retrospective cohort study of breast cancer patients with PICC insertion undergoing chemotherapy. PICC-related UEVT was diagnosed by ultrasound. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression to identify significant independent risk factors for PICC-related UEVT. The incidence and treatment of PICC-related UEVT were also analyzed. RESULTS: A total of 568 breast cancer patients with PICC undergoing chemotherapy were included, for a total of 54,769 catheter days; 8 patients (1.4%) developed PICC-related UEVT. The median time of developing UEVT was 11 days (range of 3 to 79 days). In multivariable analysis, metastasis (p = 0.002) and malposition (p = 0.013) were shown to be significant risk factors for PICC-related UEVT. All patients were treated with low-molecular-weight heparin (LMWH) and followed until PICCs were removed. None of the patients developed pulmonary embolus. CONCLUSIONS: Metastasis and malposition were significant risk factors for PICC-related UEVT in breast cancer patients. With early diagnosis and standardized anticoagulant treatment, a better clinical outcome could be achieved. Further prospective and large sample studies are needed.
PURPOSE: To identify clinical incidence, risk factors and treatment of peripherally inserted central venous catheters (PICCs)-related upper extremity venous thrombosis (UEVT) in breast cancerpatients undergoing chemotherapy. METHODS: We performed a retrospective cohort study of breast cancerpatients with PICC insertion undergoing chemotherapy. PICC-related UEVT was diagnosed by ultrasound. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression to identify significant independent risk factors for PICC-related UEVT. The incidence and treatment of PICC-related UEVT were also analyzed. RESULTS: A total of 568 breast cancerpatients with PICC undergoing chemotherapy were included, for a total of 54,769 catheter days; 8 patients (1.4%) developed PICC-related UEVT. The median time of developing UEVT was 11 days (range of 3 to 79 days). In multivariable analysis, metastasis (p = 0.002) and malposition (p = 0.013) were shown to be significant risk factors for PICC-related UEVT. All patients were treated with low-molecular-weight heparin (LMWH) and followed until PICCs were removed. None of the patients developed pulmonary embolus. CONCLUSIONS: Metastasis and malposition were significant risk factors for PICC-related UEVT in breast cancerpatients. With early diagnosis and standardized anticoagulant treatment, a better clinical outcome could be achieved. Further prospective and large sample studies are needed.
Authors: Yang Song; Shuang Liu; Ting Lou; Yuxiu Ma; Na Wang; Qinge Yong; Lin Cong; Zheng Xiao; Gao Liu Journal: J Int Med Res Date: 2019-01-11 Impact factor: 1.671