title: Incidence of thrombotic complications in patients with haematological malignancies with central venous catheters: a prospective multicentre study.
abstract: This prospective, observational and multicentre study assessed the incidence of, and risk factors for, symptomatic venous thrombotic complications after central venous catheter (CVC) positioning in patients with haematological malignancies. A total of 458 consecutive CVC insertions were registered in 416 patients (81.2% of whom had severe thrombocytopenia). Over the observation period (3 months or up to catheter removal), the incidence of events was: CVC-related deep vein thrombosis (DVT), 1.5%; lower limb DVT, 0.4%; pulmonary embolism (PE), 1.3%; fatal PE, 0.6%; CVC-related superficial thrombophlebitis, 3.9%; CVC-occlusion/malfunction of thrombotic origin, 6.1%; major arterial events, 1.1%. Severe bleeding and CVC-related infections were observed in 3.5% and 4.6% of cases respectively. A composite end point (any venous thromboembolism or superficial thrombophlebitis or CVC occlusion/malfunction) was defined in order to consider venous thrombotic events with a significant impact on clinical practice. With this criterion, the overall incidence was 12.0% (2.54 cases/1000 catheter days). No factor helped to predict venous thrombotic complications: only thrombocytopenia was associated with a weak trend for a reduced risk (odds ratio 0.52; 95% confidence interval 0.26-1.07). No severe bleeding was observed in those patients who received antithrombotic prophylaxis. This study shows that the impact on clinical practice of symptomatic CVC-related thrombotic complications is not negligible in patients with haematological malignancies.
authors.affiliation: Department of Haematology and Bone Marrow Transplantation Unit, IRCCS Fondazione Ospedale Maggiore Policlinico and University of Milan, Milan, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Cortelezzi
authors.forename: Marco
authors.initials: M
authors.lastname: Moia
authors.forename: Anna
authors.initials: A
authors.lastname: Falanga
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Pogliani
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Agnelli
authors.forename: Erminio
authors.initials: E
authors.lastname: Bonizzoni
authors.forename: Gualberto
authors.initials: G
authors.lastname: Gussoni
authors.forename: Tiziano
authors.initials: T
authors.lastname: Barbui
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology; D013921:Thrombocytopenia / Q000150:complications; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
chemical_list: D005343:Fibrinolytic Agents