Thrombosis-related complications and mortality in cancer patients with central venous devices: an observational study on the effect of antithrombotic prophylaxis.
Details
Serval ID
serval:BIB_465BF5E49929
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Thrombosis-related complications and mortality in cancer patients with central venous devices: an observational study on the effect of antithrombotic prophylaxis.
Journal
Annals of Oncology
Working group(s)
POLONORD Group
ISSN
0923-7534 (Print)
ISSN-L
0923-7534
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
18
Number
3
Pages
551-555
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study
Abstract
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.
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.
Keywords
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
Yes
Create date
14/02/2013 15:32
Last modification date
03/06/2020 5:26
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