Risk of thrombosis and infections of central venous catheters and totally implanted access ports in patients treated for cancer.
BACKGROUND
Thrombosis and infections are well known complications of central venous catheters and totally implanted access ports. These complications lead to increased costs due to prolonged hospitalisation, increased antibiotics use and need for replacement. The objectives of the study were to document the occurrence of catheter related thrombosis and infections in patients with central venous catheters and totally implanted chest ports in cancer patients and to investigate whether factor V Leiden is a risk factor for catheter related thrombosis.


METHODS
Between February 2002 and November 2004, 43 patients with central venous catheter or totally implanted access port were followed up to document the occurrence of catheter related thrombosis and infections. Patients received chemotherapy either for haematological malignancy or for solid tumours. Factor V Leiden (R506Q) was determined by restriction fragment length polymorphism analysis. Follow-up period ended in April 2007.


RESULTS
Catheter related thrombosis occurred in 4 patients (4/43; 9.3%) with a totally implanted access port. None of the 3 patients with factor V Leiden had catheter related infection or thrombosis. Catheter related infections occurred in 15 patients: 10 patients (23.3%; 10/43) with central venous catheter and 5 patients (11.6%; 5/43) with totally implanted access ports. Time to infection was 32.5 days in the central venous catheter group compared to 88 days in the totally implanted access port group.


CONCLUSIONS
A higher incidence of catheter related infections was observed in patients with central venous catheters in contrast to patients with totally implanted access ports were venous thrombosis was more frequent.
Beckers
M M J
MM
Department of Internal Medicine, University of Maastricht, The Netherlands.
Ruven
H J T
HJ
Seldenrijk
C A
CA
Prins
M H
MH
Biesma
D H
DH
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization / Q000009:adverse effects*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D015994:Incidence; D007239:Infections / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D009423:Nervous System Neoplasms / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D010361:Patients; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D014680:Veins; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology*
D000900:Anti-Bacterial Agents