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Characteristics and predictors of venous thrombosis recurrence in patients with cancer and catheter-related thrombosis.


ABSTRACT:

Background

Central venous catheters raise the risk of catheter-related thrombosis (CRT) in patients with cancer, typically affecting the upper extremity. Management of CRT involves catheter removal and anticoagulation. However, robust evidence is lacking on the optimal timing of anticoagulation relative to catheter removal.

Objectives

Our goal is to provide a better understanding of the factors that increase the risk of recurrent venous thromboembolism (VTE) in these patients.

Patients and methods

We conducted a retrospective chart review of all consecutive patients with cancer in our hospital affected by CRT between January 1, 2015, and December 31, 2017. We measured recurrence of VTE as thrombosis in any vascular bed or pulmonary embolism, for up to 2 years after diagnosis. Logistic and competing risk regression analyses were used to determine the association between different clinical factors and any VTE recurrence in patients with cancer and CRT.

Results

Of the 257 individuals meeting the inclusion criteria, 80.2% had their catheter removed; of these, 50.5% did not receive anticoagulation before the removal. Patients who did not receive anticoagulation before the removal had increased 3-month and 1-year risks of recurrent VTE (odds ratio, 5.07 [95% confidence interval [CI], 1.53-23.18]; and hazard ratio, 3.47 [95% CI, 1.34-9.01]), respectively.

Conclusions

Our study supports the use of anticoagulants before catheter removal in patients with CRT. Randomized clinical trials are recommended to establish stronger evidence pertaining to the long-term risk of VTE recurrence and the effect of catheter reinsertion.

SUBMITTER: Lipe DN 

PROVIDER: S-EPMC9391569 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Characteristics and predictors of venous thrombosis recurrence in patients with cancer and catheter-related thrombosis.

Lipe Demis N DN   Qdaisat Aiham A   Rajha Eva E   Al-Breiki Aisha A   Cruz Carreras Maria T MT   Chaftari Patrick P   Yeung Sai-Ching J SJ   Rice Terry W TW  

Research and practice in thrombosis and haemostasis 20220819 6


<h4>Background</h4>Central venous catheters raise the risk of catheter-related thrombosis (CRT) in patients with cancer, typically affecting the upper extremity. Management of CRT involves catheter removal and anticoagulation. However, robust evidence is lacking on the optimal timing of anticoagulation relative to catheter removal.<h4>Objectives</h4>Our goal is to provide a better understanding of the factors that increase the risk of recurrent venous thromboembolism (VTE) in these patients.<h4>  ...[more]

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