Internal and Emergency Medicine

, Volume 3, Issue 2, pp 117–122

Risk factors for upper limb deep vein thrombosis associated with the use of central vein catheter in cancer patients

  • Melina Verso
  • Giancarlo Agnelli
  • Pieter W. Kamphuisen
  • Walter Ageno
  • Mario Bazzan
  • Antonio Lazzaro
  • Francesco Paoletti
  • Maurizio Paciaroni
  • Stefano Mosca
  • Sergio Bertoglio
IM - Original

DOI: 10.1007/s11739-008-0125-3

Cite this article as:
Verso, M., Agnelli, G., Kamphuisen, P.W. et al. Intern Emerg Med (2008) 3: 117. doi:10.1007/s11739-008-0125-3

Abstract

Deep vein thrombosis of upper limb is a common complication of CVC in patients with cancer. In these patients the risk factors for CVC-related thrombosis are not completely defined. The purpose of this study was to identify the risk factors for CVC-related thrombosis in patients included in a randomized, double-blind, placebo-controlled study aimed at assessing the efficacy and safety of enoxaparin for the prophylaxis of CVC-related thrombosis. CVC-related thrombosis was screened by mandatory venography after 6 weeks of study treatment. A number of patient baseline characteristics were assessed as potential risk factors for CVC-related deep vein thrombosis. Crude associations between risk factors and clinical outcomes were assessed by χ2 test or Fisher’s exact test. Multiple logistic regression analysis was used to identify independent risk factors. A CVC-related thrombosis was found in 50 out of 310 patients (16.1%). At multiple logistic regression analysis, CVC tip misplaced in the upper half of superior vena cava (OR 4.05, 95%CI 1.64–10.02), left-sided CVC insertion (OR 2.29, 95%CI 1.01–5.51) and chest radiotherapy (OR 7.01, 95%CI 1.42–34.66) were independent risk factors for thrombosis. In addition to these risk factors, the presence of distant metastases (OR 9.36, 95%CI 1.53–57.05) increased the risk of thrombosis in patients who received placebo. An inadequate position of the CVC tip, left-sided CVC insertion and chest radiotherapy are independent risk factors for CVC-related thrombosis in cancer patients. Patients with distant metastases have an increased risk for thrombosis in absence of antithrombotic prophylaxis.

Keywords

Cancer Central vein catheter Risk factors for thrombosis Upper limb DVT Venous thromboembolism 

Copyright information

© SIMI 2008

Authors and Affiliations

  • Melina Verso
    • 1
  • Giancarlo Agnelli
    • 1
  • Pieter W. Kamphuisen
    • 1
    • 2
  • Walter Ageno
    • 3
  • Mario Bazzan
    • 4
  • Antonio Lazzaro
    • 5
  • Francesco Paoletti
    • 6
  • Maurizio Paciaroni
    • 1
  • Stefano Mosca
    • 7
  • Sergio Bertoglio
    • 8
  1. 1.Sezione di Medicina Interna e Cardiovascolare - Stroke Unit, Dipartimento di Medicina InternaUniversità di PerugiaPerugiaItaly
  2. 2.Division of Vascular Medicine, Department of General Internal MedicineRadboud University Nijmegen Medical CenterNijmegenThe Netherlands
  3. 3.Unità di Medicina I, Dipartimento di Medicina ClinicaUniversita’ dell’InsubriaVareseItaly
  4. 4.Servizio di Ematologia e malattie tromboticheOspedale Evangelico ValdeseTurinItaly
  5. 5.Unità Operativa di OncoematologiaOspedale di PiacenzaPiacenzaItaly
  6. 6.Sezione di Anestesia, Analgesia e Terapia Intensiva, Dipartimento di Medicina Clinica e SperimentaleUniversità di PerugiaPerugiaItaly
  7. 7.Sezione Di Radiologia Diagnostica Ed InterventisticaUniversità di PerugiaPerugiaItaly
  8. 8.Unità Operativa di Chirurgia Gastroenterologica, Dipartimento di OncologiaIstituto Nazionale per la Ricerca sul CancroGenoaItaly

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