The incidence and predictors of symptomatic venous thromboembolism associated with peripherally inserted central catheters in patients with nasopharyngeal carcinoma

Abstract

BackgroundDespite wide usage, peripherally inserted central catheter (PICC)-related venous thromboembolism (VTE) is common in nasopharyngeal carcinoma (NPC) patients.Patients and methodsThis was a retrospective cohort study of NPC patients with PICC insertions from February 2, 2007 to December 25, 2014 in Sun Yat-Sen University Cancer Centre. Univariable and multivariable logistic regression analyses were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the correlations between risk factors and symptomatic PICC-VTE.ResultsOf the 1,363 NPC patients, 76 developed symptomatic VTE. In univariable analysis, body mass index (BMI), Eastern Cooperative Oncology Group (ECOG) score, metastasis stage (M stage), and VTE history were associated with symptomatic PICC-VTE. Following multivariable adjustments, BMI (OR 0.900, p=0.007), ECOG score (OR 4.162, p=0.011), M stage (OR 2.717, p=0.019), and VTE history (OR 109.772, p<0.001) were still statistically significant.ConclusionPICC-VTE is a common complication in NPC patients, with an incidence of 5.6% in our analysis. Those with VTE history and lower BMI and worse ECOG performance score metastatic NPC patients are more susceptible to symptomatic PICC-related thrombosis and thus may require prophylactic anticoagulation.

Symptomatic venous thromboembolism associated with peripherally inserted central catheters predicts a worse survival in nasopharyngeal carcinoma: results of a large cohort, propensity score–matched analysis

“…General items include stage of carcinoma, thrombosis history, age, comorbidities, catheter insertion, chemotherapy, surgery and others [22–24]. We previously have reported that VTE history, BMI, ECOG performance score and metastasis stage were significantly associated with symptomatic PICC-VTE in NPC patients [4]. In our study, the values of pre-treatment Plt and FDP were significantly higher in the VTE group.…”

“…Furthermore, since intravenous infusion was administered for NPC patients for a long duration, they experience long term stay in bed or without active moving, which contributes to the formation of VTE. We previously reported that the incidence of PICC-VTE in NPC patients was 5.6% [4], and the figure tended to be even higher when asymptomatic thromboembolism was taken into consideration [5]. Although many cases of VTE are moderate and can be cured, it may cause recurrence, post-thrombotic syndrome or even pulmonary embolism [6, 7].…”

The incidence of asymptomatic thrombosis related to peripherally inserted central catheter in adults: A systematic review and meta‐analysis People’s

“…The ECOG score reflects the patient's activity status (Greipp et al., 1998 ). A higher ECOG score indicates poorer activity status (Liang et al., 2018 ). Previous studies found that lower patient activity was a risk factor of PICC‐RT (Yi et al., 2014 ; Yuxiu et al., 2015 ).…”

Map of thrombogenesis in viral infections and viral-driven tumours

“…3) compared to other solid tumours [102,103]. Researchers appoint to increased platelet aggregation and a blood hypercoagulable state in NPC patients, which might be key factors in triggering thrombosis [104][105][106]. However, in these patients, these mechanisms seem to be only relevant in the context of thrombosis related to the use of central catheters rather than thrombogenesis induced by the tumour biology itself [103,106].…”