Thrombosis-related complications and mortality in cancer patients with central venous devices: an observational study on the effect of antithrombotic prophylaxis.

Détails

ID Serval
serval:BIB_465BF5E49929
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Thrombosis-related complications and mortality in cancer patients with central venous devices: an observational study on the effect of antithrombotic prophylaxis.
Périodique
Annals of Oncology
Auteur(s)
Fagnani D., Franchi R., Porta C., Pugliese P., Borgonovo K., Bertolini A., Duro M., Ardizzoia A., Filipazzi V., Isa L., Vergani C., Milani M., Cimminiello C.
Collaborateur(s)
POLONORD Group
ISSN
0923-7534 (Print)
ISSN-L
0923-7534
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
18
Numéro
3
Pages
551-555
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study
Résumé
BACKGROUND: Recent guidelines do not recommend antithrombotic prophylaxis (AP) to prevent catheter-related thrombosis in cancer patients with a central line.
PATIENTS AND METHODS: This study assessed the management of central lines in cancer patients, current attitude towards AP, catheter-related and systemic venous thromboses, and survival.
RESULTS: Of 1410 patients enrolled, 1390 were seen at least once in the 6-month median follow-up. Continuous AP, mainly low-dose warfarin, was given to 451 (32.4%); they were older, with a more frequent history of venous thromboembolism (VTE), and more advanced cancer. There was no difference in catheter-related thrombosis in patients given AP or not (2.8% and 2.2%, odds ratio 1.29, 95% confidence interval 0.64-2.6). The median time to first catheter-related complication was 120 days. Systemic VTE including deep and superficial thromboses and pulmonary embolism, were less frequent with AP (4% versus 8.2%, P = 0.005). Mortality was also lower (25% versus 44%, P = 0.0001). Multiple logistic regression analysis found only advanced cancer and no AP significantly associated with mortality. No major bleeding was recorded with AP.
CONCLUSIONS: Current AP schedules do not appear to prevent catheter-related thrombosis. Systemic VTE and mortality, however, appeared lower after prophylaxis.
Mots-clé
Catheterization, Central Venous/adverse effects, Catheterization, Central Venous/instrumentation, Catheters, Indwelling/adverse effects, Female, Fibrinolytic Agents/therapeutic use, Humans, Italy/epidemiology, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Neoplasms/complications, Neoplasms/mortality, Odds Ratio, Prospective Studies, Pulmonary Embolism/etiology, Pulmonary Embolism/mortality, Risk Assessment, Time Factors, Treatment Outcome, Venous Thrombosis/etiology, Venous Thrombosis/mortality, Warfarin/therapeutic use
Pubmed
Web of science
Open Access
Oui
Création de la notice
14/02/2013 16:32
Dernière modification de la notice
08/05/2019 17:56
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