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.
| Original language | English |
|---|---|
| Pages (from-to) | 551-555 |
| Number of pages | 5 |
| Journal | Annals of Oncology |
| Volume | 18 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2007 |
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Keywords
- Cancer
- Catheter-related thrombosis
- Central venous catheters
- Deep vein thrombosis
- Low-dose warfarin
- Pulmonary embolism
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Thrombosis-related complications and mortality in cancer patients with central venous devices : An observational study on the effect of antithrombotic prophylaxis. / Fagnani, Daniele; Franchi, R.; Porta, C.; Pugliese, P.; Borgonovo, K.; Bertolini, A.; Duro, M.; Ardizzoia, A.; Filipazzi, V.; Isa, L.; Vergani, C.; Milani, M.; Cimminiello, C.
In: Annals of Oncology, Vol. 18, No. 3, 03.2007, p. 551-555.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Thrombosis-related complications and mortality in cancer patients with central venous devices
T2 - An observational study on the effect of antithrombotic prophylaxis
AU - Fagnani, Daniele
AU - Franchi, R.
AU - Porta, C.
AU - Pugliese, P.
AU - Borgonovo, K.
AU - Bertolini, A.
AU - Duro, M.
AU - Ardizzoia, A.
AU - Filipazzi, V.
AU - Isa, L.
AU - Vergani, C.
AU - Milani, M.
AU - Cimminiello, C.
PY - 2007/3
Y1 - 2007/3
N2 - 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.
AB - 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.
KW - Cancer
KW - Catheter-related thrombosis
KW - Central venous catheters
KW - Deep vein thrombosis
KW - Low-dose warfarin
KW - Pulmonary embolism
UR - http://www.scopus.com/inward/record.url?scp=33847642662&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33847642662&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdl431
DO - 10.1093/annonc/mdl431
M3 - Article
C2 - 17158773
AN - SCOPUS:33847642662
VL - 18
SP - 551
EP - 555
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 3
ER -