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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. and Moua, T. and Williams, E. C. and Verso, M. and Agnelli, G. and Couban, S. and Young, Annie and De Cicco, M. and Biffi, R. and van Rooden, C. J. and Huisman, M. V. and Fagnani, D. and Cimminiello, C. and Moia, M. and Magagnoli, M. and Povoski, S. P. and Malak, S. F. and Lee, A. 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, 9 (2). p. 312. ISSN 15387933

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URL of Published Version: http://dx.doi.org/10.1111/j.1538-7836.2010.04126.x

Identification Number/DOI: doi: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

Type of Work:Article
Date:2011 (Publication)
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:1Cancer Research UK Clinical Trials Unit
Subjects:R Medicine (General)
Institution:University of Birmingham
Copyright Holders:Wiley
ID Code:637
Refereed:YES
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