Objectives:

Central venous access is needed to facilitate chemotherapy for many cancer patients. Central venous catheter-related thrombosis (CVCT) is a major complication that can cause significant morbidity and mortality. We sought to explore the rate of CVCT in a general cancer population in Australia and to identify factors associated with increased risk of thrombosis.

Design:

This is a multi-centre retrospective cohort study.

Setting and participants:

We analysed key patient, treatment, and cancer-related factors for 317 patients with cancer and central venous catheters inserted for systemic therapy.

Main outcome measures:

Symptomatic CVCT confirmed with imaging and management of patients with CVCT.

Results:

A total of 402 cases of central line insertion were analysed. Central venous catheter-related thrombosis occurred in 24 patients (6.0%). Having a peripherally inserted central catheter (PICC; HR = 3.78, 95% CI = 1.28-11.19, P = .02) compared with an implantable port and a body mass index of ⩾25.0 kg/m² (HR = 3.60, 95% CI = 1.31-9.85, P = .01) were independently associated with increased risk of thrombosis. Central venous catheter-related thrombosis was managed mostly with removal of the catheter (19 of 24 cases) and anticoagulation, including direct-acting oral anticoagulants in 5 patients.

Conclusions:

This work explored rates of CVCT in a general cancer population, observing increased rates in those with PICCs or increased body mass index.

中文翻译：

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癌症中的中心静脉导管血栓形成：一项调查危险因素和当代管理趋势的多中心回顾性研究。

目标：

许多癌症患者需要中心静脉通路来促进化疗。中心静脉导管相关血栓形成 (CVCT) 是一种主要的并发症，可导致显着的发病率和死亡率。我们试图探索澳大利亚普通癌症人群中 CVCT 的发生率，并确定与血栓形成风险增加相关的因素。

设计：

这是一项多中心回顾性队列研究。

设置和参与者：

我们分析了 317 名癌症患者和插入中心静脉导管进行全身治疗的关键患者、治疗和癌症相关因素。

主要观察指标：

有症状的 CVCT 通过 CVCT 患者的影像学和管理得到证实。

结果：

共分析了 402 例中心线插入病例。24 名患者（6.0%）发生中心静脉导管相关血栓形成。与植入式端口相比，外周插入中心导管 (PICC; HR = 3.78, 95% CI = 1.28-11.19, P  = .02)，体重指数为 25.0 kg/m ² (HR = 3.60, 95% CI = 1.31-9.85，P  = .01）与血栓形成风险增加独立相关。中心静脉导管相关血栓形成主要通过拔除导管（24 例中的 19 例）和抗凝治疗，包括 5 例患者的直接作用口服抗凝剂。

结论：

这项工作探讨了普通癌症人群中 CVCT 的发生率，观察到 PICC 患者的发生率增加或体重指数增加。