The impact of antithrombotic prophylaxis on infectious complications in cancer patients with central venous catheters: an observational study.

Détails

ID Serval
serval:BIB_4F18224ED003
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The impact of antithrombotic prophylaxis on infectious complications in cancer patients with central venous catheters: an observational study.
Périodique
Blood Coagulation and Fibrinolysis
Auteur(s)
Fagnani D., Bertolini A., Catena L., Tomirotti M., Visini M., Alatri A., De Paoli A., Aondio G.M., Milani M., Arpaia G., Cimminiello C., Franchi R., Franchi R., Porta C., Pugliese P., Borgonovo K., Duro M., Ardizzoia A., Filipazzi V., Isa L., Vergani C., Carpenedo M., Viale P.
Collaborateur(s)
POLONORD Group
ISSN
1473-5733 (Electronic)
ISSN-L
0957-5235
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
20
Numéro
1
Pages
35-40
Langue
anglais
Notes
Publication types: Journal Article
Résumé
Infections in cancer patients after implantation of a central venous device (CVD) are not infrequent and are potentially serious. The possibility of limiting this complication with antithrombotic drugs is still debated. For this observational study, we recorded the routine management of CVD in cancer patients in 18 oncology centers in Lombardy (northern Italy), assessing the effect of antithrombotic prophylaxis on catheter-related infections. Out of 1410 patients enrolled, 451 received antithrombotic prophylaxis continuously after implantation of the central line. During a median follow-up of 30 months, 57 catheter-related infections were reported in the 1390 patients seen at least once at follow-up visits (4.1% of the whole series), giving an overall incidence of 0.10 infections per 1000 catheter days. This complication was significantly more frequent among patients with an indwelling central venous catheter, or peripherally inserted catheter, than among those with a port device, and the group not given antithrombotic prophylaxis had 0.14 infective complications/1000 CVD days compared with 0.05/1000 CVD days (odds ratio 2.4; 95% confidence interval 1.7-5.0) for those treated. Antithrombotic prophylaxis protected against infections at the catheter exit site and track but not against systemic infections. Confirming earlier evidence, this study found a reduction in catheter-related infections in patients given antithrombotic prophylaxis. However, this reduction, reflecting local infections, seems unlikely to be one of the mechanisms explaining the lower mortality among our patients treated with anticoagulants.
Mots-clé
Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Catheterization, Central Venous/adverse effects, Cohort Studies, Female, Fibrinolytic Agents/pharmacology, Follow-Up Studies, Heparin, Low-Molecular-Weight/pharmacology, Humans, Italy, Male, Middle Aged, Neoplasm Staging, Neoplasms/complications, Neoplasms/drug therapy, Prospective Studies, Prosthesis-Related Infections/complications, Prosthesis-Related Infections/prevention & control, Regression Analysis, Treatment Outcome, Warfarin/pharmacology
Pubmed
Création de la notice
14/02/2013 13:32
Dernière modification de la notice
03/06/2020 5:26
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