Catheter-related thrombosis (CRT) is a serious complication in hematological patients, but

Catheter-related thrombosis (CRT) is a serious complication in hematological patients, but the risk factors for its occurrence are not well established. radiological evidence of CRT was E-7050 preceded by clinical symptoms. However, in 9/27 (33.3?%), CRT was clinically asymptomatic. The median times to symptomatic and asymptomatic CRT were 17 (range 1C49) and 8 (range 1C16) catheter days, respectively. In univariate analysis, the risk factors for CRT were exit-site contamination (ESI) (value was <0.10 in the univariate analysis were submitted to a multivariate conditional logistic regression model. Backward stepwise regression E-7050 procedures were used to develop the final multivariate model. A value <0.05 was considered as significant. Odds ratios (ORs) and 95?% CIs (confidence intervals) were calculated on the basis of the final model. All statistical analyses were performed using Statistica for Windows (StatSoft, Inc. 2001). Results Patients and CVC positioning A total of 200 cases of CVC positioning in 104 patients with a median age of 45?years (range 18C76) were enrolled in the study. The main patient and catheter characteristics are presented in Table?1. Table?1 Patient and catheter characteristics The overall median follow-up time was 27?days (range 4C183), for a total of 6,098 catheter days. The median follow-up of patients who developed CRT was 22?days (range 12C49). In 17/27 cases, the catheter was removed after confirming CRT. All the patients with CRT were treated with enoxaparin, with the therapeutic dose adjusted to the platelet count and the clinical symptoms of thrombocytopenia. CRT incidence Of the total of 200 insertions, CRT was confirmed in 27 (13.5?%). Radiological evidence of CRT was preceded by clinical symptoms in 18 of these 27 cases E-7050 (66.6?%). However, in 9 of these 27 patients (33?%) and in 4.5?% of the total group of 200 insertions, CRT was clinically silent. The median times to symptomatic CRT and clinically asymptomatic CRT were 17 catheter days (range 1C49) and 8 catheter days (range 1C16), respectively. Thrombosis was confirmed within 15?days from E-7050 catheter placement Rabbit Polyclonal to CDH24 in 11 cases, between 15 and 30?days in 14 cases, and beyond 30?days in 2 cases. CRT was associated with CVC-related infections in 13/27 cases (48.1?%). Thirteen cases of ESI were present, and additionally, 6 cases met the criteria of CRBSI. Based on the Pearson chi-square test, we analyzed incidence of CRT in the different subgroups of patients. The incidence rate of CRT differed significantly between groups of patients stratified by a number of prior chemotherapy lines, CRBSI, exit-site contamination, and contamination by Coagulase-negative staphylococci (CoNS) (Table?2). In contrast, no association was found between the incidence rate of CRT and age of patient, prior CRT, underlying hematological disorder, time of cytostatic infusion (>12 vs. 12?h), type of chemotherapy (cisplatin-based chemotherapy vs. others), tip localization, D-dimer concentration, or catheter insertion site. Table?2 Incidence of venous catheter-related thrombosis in the subgroups of patients Risk factors Based on univariate logistic regression analysis, we identified four risk factors of CRT (Table?3). Table?3 Univariate analysis of risk factors of catheter-related thrombosis Multiple logistic regression analysis revealed two independent risk factors of CRT: exit-site infection (OR 5.01; 95?% CI 1.6C6.3; P?=?0.006) and two or more prior chemotherapy lines (OR 3.57; 95?% CI 1.27C10.11; P?=?0.015). Discussion CRT is a serious complication in hematological patients. Few studies relating to the incidence of CRT and associated risk factors in patients treated for hematological disorders have been published. Therefore, our aims were to evaluate this incidence and to identify risk factors for CRT in patients hospitalized in our center. In all the studies reported in the literature, CRT was investigated in patients in whom the catheters were inserted via different types of vascular access port. The catheters that were of either E-7050 the tunneled or non-tunneled types were impregnated or unimpregnated, placed in peripheral or central veins, and had different numbers of lumen. Our study was carried out on a large group of patients with the same.

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