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PICC thrombosis in patients with lung cancer

"To determine the incidence and risk factors associated with peripherally inserted central catheter-related thrombosis (PICC-RT) in patients with lung cancer" Chen et al (2020).

"To determine the incidence and risk factors associated with peripherally inserted central catheter-related thrombosis (PICC-RT) in patients with lung cancer" Chen et al (2020).

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Abstract:

Aims: To determine the incidence and risk factors associated with peripherally inserted central catheter-related thrombosis (PICC-RT) in patients with lung cancer.

Design: A retrospective cross-sectional design.

Methods: Patients with lung cancer receiving PICC insertion during 1 March 2014-31 May 2019 at a tertiary hospital in Shanghai, China were enrolled (N = 748). Symptomatic PICC-RT was confirmed by Doppler ultrasonography in the presence of clinical symptoms and signs. Univariate and multivariate logistic regression analyses were performed to identify risk factors of symptomatic PICC-RT.

Results: Among the patients (mean age, 60.7 years; males, 67.1%), 55 (7.35%) had symptomatic PICC-RT. Based on the multivariate analysis, history of smoking [OR 2.49 (1.13-5.46), p < .05], use of Carboplatin [OR 2.23 (1.19-4.17), p < .05] or Docetaxel [OR 7.23 (1.65-31.56), p < .05], PICC size [OR 3.52 (1.78-6.99), p < .001], and level of D-dimer [OR 5.32 (2.39-11.83), p < .001] were significant risk factors of PICC-RT.

Conclusion: Several modifiable factors (e.g., PICC size and level of D-dimer) were related to PICC-RT. In the future, prospective studies are warranted to examine whether those factors could increase the risk of PICC-RT. Meanwhile, healthcare professionals are recommended to perform a comprehensive assessment of the patients receiving PICC insertion. Close attention should be paid to those at risk for PICC-RT.

Impact: Identification of risk factors associated with PICC-RT is an important step towards individualizing the care plan for patients receiving PICC. Our findings provided evidence for the management of PICC-RT in patients with lung cancer. In clinical practice, nurses could deliver appropriate interventions against modifiable risk factors to reduce the risk of PICC-RT.

Reference:

Chen P, Wan G, Zhu B. Incidence and risk factors of symptomatic thrombosis related to peripherally inserted central catheter in patients with lung cancer. J Adv Nurs. 2020 Nov 29. doi: 10.1111/jan.14666. Epub ahead of print. PMID: 33249623.

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