title: Peripherally Inserted Central Catheter-Related Vein Thrombosis in Patients With Lung Cancer.
abstract: BACKGROUND
  Peripherally inserted central venous catheters (PICCs) are widely used in patients with cancer. Catheter usage is one of the risk factors for venous thromboembolism. We aimed to scrutinize the incidence and risk factors for PICC-related upper extremity venous thrombosis (UEVT) in patients with lung cancer receiving chemotherapy.
  
  
  METHODS
  We performed a retrospective cohort study of patients with lung cancer with PICC insertion undergoing chemotherapy. Symptomatic PICC-UEVT was diagnosed by ultrasound. The relationship between chemotherapeutic agent exposure and PICC-UEVT was evaluated. Patient-, catheter-, and insertion-related factors were analyzed in univariable and multivariable logistic regression to identify significant independent risk factors for PICC-UEVT in patients with lung cancer.
  
  
  RESULTS
  A total of 328 patients with lung cancer having PICC undergoing chemotherapy were included, for a total of 34 895 catheter days. Seventeen (5.2%) patients developed PICC-related UEVT, with an incidence of 0.49 per 1000 catheter days. In multivariable logistic analysis, advanced disease was shown to be a significant risk factor for PICC-UEVT (odds ratio [OR]: 4.9; 95% confidence interval [CI]: 1.4-16.7; P = .011). Patients treated with etoposide had a higher risk of PICC-related UEVT (OR: 3.6; 95% CI: 1.1-12.1; P = .042). Patients were followed up after PICC removal for a median duration of 246 days. None of the patients developed pulmonary embolism.
  
  
  CONCLUSIONS
  Patients with lung cancer harboring an advanced disease or treating with etoposide were at higher risk of PICC-UEVT.
authors.affiliation: 1 Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Jun Ren
authors.initials: JR
authors.lastname: Kang
authors.affiliation: 1 Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Li Hai
authors.initials: LH
authors.lastname: Long
authors.affiliation: 1 Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Sun Wen
authors.initials: SW
authors.lastname: Yan
authors.affiliation: 2 Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy Of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Wang Wei
authors.initials: WW
authors.lastname: Wei
authors.affiliation: 2 Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy Of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Han Zhi
authors.initials: HZ
authors.lastname: Jun
authors.affiliation: 1 Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D015331:Cohort Studies; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents; D005047:Etoposide
keywords: central venous catheter thrombosis; chemotherapy; lung cancer; upper extremity deep vein thrombosis; venous thromboembolism