BACKGROUND The use of central venous catheter with peripheral insertion (PICC) has increased rapidly in recent years particularly in cancer patients because they represent a stable and safe vascular access to administer irritants or vesicants therapies. However, the benefit provided may occasionally be affected by severe complications. An observational study conducted at our Institute, showed a significant increase of thromboembolic risk in neuro-oncological patients compared to general cancer population (16.3% vs 6.7% respectively). For this reason, it is essential to identify independent risk factors in order to avoid preventable harm. MATERIAL AND METHODS Neuro-oncological patients with PICC that developed a thromboembolic event were retrospectively analyzed. We evaluated clinical data, BMI, KPS, steroid therapies and anticoagulants at the time of positioning of the PICC and at the onset of the thrombotic event. RESULTS A total of 90 neuro-oncological patients have been analyzed. The most common histology was represented by glioblastoma, followed by anaplastic astrocytoma, primary central nervous system lymphoma, grade II glioma. 17.6% of patients were at first diagnoses, 41.6% were at the first recurrence, and the remaining patients were at the second or third recurrence. The median KPS was 90 (range 80–100), and the median ECOG was 0 (range 0–2). Overall, 14% patients developed thromboembolic events within a median time of 34.5 days (range 5–146) after PICC implantation. Among these, 64% of patients was considered overweight. No patients were on anticoagulant therapy but all were treated with a median dose of 5.5 mg of steroids (range 3,5-12), stable between PICC insertion and onset of adverse event. CONCLUSION 64% of patients who developed a thromboembolic event had BMI >28 at the time of PICC insertion, suggesting a possible trend towards a risk of developing PICC related thrombosis in overweight/obese patients. Other independent risk factors for PICC associated complications seems to be amount of previous chemotherapies administered: 82% of patients who developed thrombotic complications had already undergone at least one line of chemotherapy before PICC placement, suggesting this condition as a possible risk factor for the onset of the event. Also failed positioning attempts could damage vascular endothelium, contributing to the onset of thrombotic complications. An accurate anamnesis and a physical evaluation with particular attention to the presence of malnutrition could help in the in the early identification of independent risk factors that could farther negatively influence the outcome of neuro-oncological patients.

中文翻译：

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P12.04 体重指数：神经肿瘤患者可能与 PICC 相关的并发症风险因素

背景技术近年来，具有外周插入的中心静脉导管 (PICC) 的使用迅速增加，特别是在癌症患者中，因为它们代表了一种稳定和安全的血管通路，可以进行刺激剂或起泡剂治疗。但是，所提供的好处有时可能会受到严重并发症的影响。在我们研究所进行的一项观察性研究显示，与一般癌症人群相比，神经肿瘤患者的血栓栓塞风险显着增加（分别为 16.3% 和 6.7%）。因此，必须确定独立的风险因素以避免可预防的伤害。材料和方法 回顾性分析发生血栓栓塞事件的 PICC 神经肿瘤患者。我们评估了临床数据、BMI、KPS、在放置 PICC 时和血栓事件发生时使用类固醇治疗和抗凝剂。结果 共分析了 90 名神经肿瘤患者。最常见的组织学以胶质母细胞瘤为代表，其次是间变性星形细胞瘤、原发性中枢神经系统淋巴瘤、II级胶质瘤。17.6%的患者为首次诊断，41.6%为首次复发，其余患者为第二次或第三次复发。中位 KPS 为 90（范围 80-100），中位 ECOG 为 0（范围 0-2）。总体而言，14% 的患者在 PICC 植入后的中位时间 34.5 天（范围 5-146 天）内发生血栓栓塞事件。其中，64%的患者被认为超重。没有患者接受抗凝治疗，但所有患者均接受了中位剂量 5.5 mg 的类固醇（范围 3，5-12)，在 PICC 插入和不良事件发生之间稳定。结论 64% 发生血栓栓塞事件的患者在置入 PICC 时 BMI > 28，表明超重/肥胖患者发生 PICC 相关血栓形成风险的可能趋势。PICC 相关并发症的其他独立危险因素似乎是既往化疗的数量：82% 发生血栓并发症的患者在 PICC 放置前已经接受了至少一种化疗，这表明这种情况可能是事件。失败的定位尝试也可能损害血管内皮，导致血栓并发症的发生。