title: Upper extremity venous thrombosis in patients with cancer with peripherally inserted central venous catheters: a retrospective analysis of risk factors.
abstract: OBJECTIVE
  Peripherally inserted central catheters (PICCs) are often used in place of mediport catheters because of cost and lack of operating room time and to prevent delays in therapy. One common complication associated with their use is upper extremity venous thrombosis (UEVT). The purpose of this study was to ascertain risk factors associated with an increased risk of PICC-associated UEVT in patients with cancer.
  
  
  METHODS
  Retrospective analysis identified 237 patients with cancer who received PICCs at the Dallas Veterans Affairs Medical Center from 2006 to 2009. We analyzed many risk factors, including PICC infection (PI), use of erythropoiesis-stimulating agents (ESAs), antiplatelet agents (APAs), treatment dose anticoagulation (TDA), and bevacizumab.
  
  
  RESULTS
  Of 237 patients, 36 (15%) were found to have UEVT. Stepwise logistic regression analysis showed risk factors positively associated with UEVT were use of ESAs (odds ratio [OR], 10.66; 95% CI, 2.25 to 50.49), hospitalization (OR, 2.38; 95% CI, 1.05 to 5.39), PI (OR, 2.46; 95% CI, 1.03 to 5.86), and TDA (OR, 8.34; 95% CI, 2.98 to 23.33), whereas patients receiving APAs had a lower risk of UEVT (OR, 0.25; 95% CI, 0.07 to 0.92).
  
  
  CONCLUSIONS
  Specific factors significantly increase the risk of UEVT in patients with cancer with PICCs, whereas use of APAs seems to have a protective effect against UEVT. These results may aid in the development of a predictive model for identifying patients at high risk of UEVT who may benefit from APAs, as well as in determining preventive strategies for reducing the risk of PICC-associated UEVT.
authors: University of Texas Southwestern Medical Center, Department of Palliative Care, Dallas, TX 75390-8889, USA. danielahn@gmail.com
authors: Daniel H
authors: DH
authors: Ahn
authors: Henrik Bo
authors: HB
authors: Illum
authors: David H
authors: DH
authors: Wang
authors: Anant
authors: A
authors: Sharma
authors: Jonathan E
authors: JE
authors: Dowell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D034941:Upper Extremity; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D006397:Hematinics
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