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Article first published online: 19 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 17, pages 4197–4205, 1 September 2010
How to Cite
Revel-Vilk, S., Yacobovich, J., Tamary, H., Goldstein, G., Nemet, S., Weintraub, M., Paltiel, O. and Kenet, G. (2010), Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer. Cancer, 116: 4197–4205. doi: 10.1002/cncr.25199
S. Revel-Vilk, J. Yacobovich, G. Goldstein, S. Nemet, and G. Kenet were responsible for data collection. S. Revel-Vilk and O. Paltiel were responsible for statistical analysis and manuscript preparation. J. Yacobovich, H. Tamary, O. Paltiel, M. Weintraub, and G. Kenet contributed to the revision of the manuscript.
We thank the nurses and physicians who cared for these patients and their families.
- Issue published online: 23 AUG 2010
- Article first published online: 19 AUG 2010
- Manuscript Accepted: 24 NOV 2009
- Manuscript Revised: 21 NOV 2009
- Manuscript Received: 16 OCT 2009
- deep vein thrombosis;
- thrombotic complications;
- central venous catheter;
- risk factors;
The use of central venous catheters (CVCs) has greatly improved the quality of care in children with cancer, yet these catheters may cause serious infectious and thrombotic complications. The aim of this prospective registry study was to assess the host and CVC-related risk factors for CVC-created thrombotic complications.
Patients undergoing CVC insertion for chemotherapy were followed prospectively for CVC complications. At the time of enrollment, demographic, clinical, and CVC-related data, and family history of thrombosis were collected. Survival and Cox regression analyses were performed.
A total of 423 CVCs were inserted into 262 patients for a total of 76,540 catheter days. The incidence of CVC-related deep-vein thrombosis (DVT) was 0.13 per 1000 catheter-days (95% confidence interval [CI], 0.06-0.24). Insertion of peripherally inserted central catheters (PICCs) and insertion in an angiography suite significantly increased the risk of symptomatic CVC-related DVT. The incidence of CVC occlusion was 1.35 per 1000 catheter-days (95% CI, 1.1-1.63). Positive family history of thrombosis significantly increased the risk of CVC occlusion (hazard ratio [HR], 2.16; 95% CI, 1.2-3.8). The CVC-related risk factors were insertion of Hickman catheters, insertion in angiography suite, and proximal-tip location. Patients developing at least 1 episode of both CVC occlusion and infection had an increased risk for developing symptomatic CVC-related DVT (HR, 4.15; 95% CI, 1.2-14.4).
Both patient-related and CVC-related factors are associated with higher risk of symptomatic thrombotic complications. These risk factors could be used in the clinical setting and in developing future studies for CVC thromboprophylaxis. Cancer 2010. © 2010 American Cancer Society.