Risk factors for catheter-related thrombosis (CRT) in cancer patients : a patient-level data (IPD) meta-analysis of clinical trials and prospective studies
Saber, W., Moua, T., Williams, E. C., Verso, M., Agnelli, G., Couban, S., Young, Annie M., De Cicco, M., Biffi, R., van Rooden, C. J., Huisman, M. V., Fagnani, D., Cimminiello, C., Moia, M., Magagnoli, M., Povoski, S. P., Malak, S. F. and Lee, Agnes Y. Y.. (2011) Risk factors for catheter-related thrombosis (CRT) in cancer patients : a patient-level data (IPD) meta-analysis of clinical trials and prospective studies. Journal of Thrombosis and Haemostasis, Vol.9 (No.2). pp. 312-319. ISSN 1538-7933Full text not available from this repository.
Official URL: http://dx.doi.org/10.1111/j.1538-7836.2010.04126.x
Background: Knowledge of independent, baseline risk factors for catheter-related thrombosis (CRT) may help select adult cancer patients who are at high risk to receive thromboprophylaxis. Objectives: We conducted a meta-analysis of individual patient-level data to identify these baseline risk factors. Patients/Methods: MEDLINE, EMBASE, CINAHL, CENTRAL, DARE and the Grey literature databases were searched in all languages from 1995 to 2008. Prospective studies and randomized controlled trials (RCTs) were eligible. Studies were included if original patient-level data were provided by the investigators and if CRT was objectively confirmed with valid imaging. Multivariate logistic regression analysis of 17 prespecified baseline characteristics was conducted. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Results: A total sample of 5636 subjects from five RCTs and seven prospective studies was included in the analysis. Among these subjects, 425 CRT events were observed. In multivariate logistic regression, the use of implanted ports as compared with peripherally implanted central venous catheters (PICCs), decreased CRT risk (OR, 0.43; 95% CI, 0.23–0.80), whereas past history of deep vein thrombosis (DVT) (OR, 2.03; 95% CI, 1.05–3.92), subclavian venipuncture insertion technique (OR, 2.16; 95% CI, 1.07–4.34) and improper catheter tip location (OR, 1.92; 95% CI, 1.22–3.02), increased CRT risk. Conclusions: CRT risk is increased with use of PICCs, previous history of DVT, subclavian venipuncture insertion technique and improper positioning of the catheter tip. These factors may be useful for risk stratifying patients to select those for thromboprophylaxis. Prospective studies are needed to validate these findings.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
|Divisions:||Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
|Library of Congress Subject Headings (LCSH):||Blood coagulation disorders -- Risk factors, Thrombosis -- Risk factors, Cancer -- Patients, Meta-analysis, Clinical trials|
|Journal or Publication Title:||Journal of Thrombosis and Haemostasis|
|Publisher:||Wiley-Blackwell Publishing Ltd.|
|Official Date:||February 2011|
|Page Range:||pp. 312-319|
|Access rights to Published version:||Restricted or Subscription Access|
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