Incidence and Predictive Factors of Symptomatic Thrombosis Related to Peripherally Inserted Central Catheters In Chemotherapy Patients
Notice bibliographique
Résumé
Abstract Abstract 4206 Background: The use of peripherally inserted central catheter (PICC) lines has significantly enhanced the management of chemotherapy patients. While deep vein thrombosis (DVT) of a catheterized vein is a common and potentially serious complication, such thromboses are frequently asymptomatic. Indeed, the true incidence of symptomatic catheter-related DVT in cancer patients remains unclear, and there is a lack of reliable data on the risk factors of catheter-related thrombosis. Moreover, little work has focused on predictive factors of symptomatic events related specifically to PICC lines in chemotherapy patients. Methods: We performed a retrospective cohort study of consecutive cancer patients who received an ultrasound guided PICC line for the administration of chemotherapy at The Ottawa Hospital between September 1, 2009 and December 31, 2009. Relevant demographic, clinical and laboratory characteristics were collected, including factors previously suggested as being predictive of catheter-related DVT. Univariate and multivariate logistic regression analyses were performed for symptomatic PICC-related DVT, defined as a clot in one or more of the deep veins of the catheterized arm leading to and confirmed by Doppler ultrasound. Results: In total, 340 cancer patients obtained PICC lines for the administration of chemotherapy. Of these patients, 19 (5.6%; 95% CI: 3.6–8.6) developed symptomatic PICC-related DVT. In the univariate analysis, demographic factors were not significant predictors of PICC-related DVT, including gender, age, body mass index and smoking status. Interestingly, factors previously suggested as being associated with central venous catheter-related clots in prior studies were not significant determinants in our analysis; in particular, side of line placement (p=0.281), catheter tip location (p=0.539), number of lumens (p=0.911), number of insertion attempts (p=0.964), and catheter repositioning (p=0.731) were not predictive. Importantly, patients with diabetes were three times more likely to develop PICC-related DVT (OR 3.0, p=0.039), while the presence of chronic obstructive pulmonary disease (COPD) or metastatic cancer increased the odds of developing PICC-related DVT (OR 3.3, p=0.078; OR 2.3, p=0.083 respectively). Diabetes remained a significant risk factor after adjustment for effect of metastases and COPD (OR 3.175, p=0.039). Further, the presence of metastases was a significant predictor (OR 3.34, p=0.024) in our multivariate model. Conclusion: Symptomatic PICC-related DVT are frequent in cancer patients receiving chemotherapy. Previously described factors associated with catheter-related thrombosis, such as tip location, lumen size, and side of catheter, were not predictive of PICC-related DVT in our study. In addition, known risk factors for DVT, including gender and obesity, were not predictive, which may suggest an alternate pathophysiologic process in this particular population. Diabetes, advanced disease and COPD appear to increase the risk of developing PICC-related DVT in chemotherapy patients, although the biologic mechanism of this result is not clear. To our knowledge, this is the largest study to date to exclusively examine PICC-associated DVT in cancer patients. Further studies with larger number of patients are required to better characterize risk factors and their relative impact in developing PICC-related DVT. Disclosures: Tay: Ortho-Biotech: Honoraria; Pfizer: Honoraria.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».