Cuidados paliativos y medicina

Abstracto

3Venous Thrombosis Associated with Peripherally Inserted Central Catheters in Oncology Patients: A Single Institutional Experience

Tarek Assi, Joseph Kattan, Toni Ibrahim, Tania Moussa, Elie El Rassy, Samer Tabchi, Ralph Chebib, Georges Chahine, Fadi Nasr, Fadi El Karak and Marwan Ghosn

Purpose: The use of peripherally inserted central catheters (PICCs) had gradually increased in recent years,especially incancer patients, as it facilitates blood sampling and treatment administration. Unfortunately, they were associated with a high incidence of complications that limited their widespread use. The purpose of this study is to evaluate the characteristics of oncology patients presenting for complications of their PICC lines and to establish possible associated factors such as age, sex, type of cancer, site of insertion of PICC in our institution. Materials and methods: This retrospective study includes all cancer patients who underwent placement of PICC, from January 2012 till December 2013, under radiology guidance at Hotel-Dieu de France university hospital. All patients were evaluated at enrollment for age, sex, site of PICC insertion, type of neoplasia (solid vs. hematologic malignancy), and followed up for complications for a minimum of two months. Results: During the recruitment period, forty-four patients were enrolled in our study with 54.4% women and 45.6% men. Mean and median age at PICC insertions were 57 and 59 years respectively (standard deviation 16).Nineteen patients (43.2%) had hematologic malignancies and twenty-five had solid tumors (56.8%). Complications including dislodgement, infection, and thrombosis were encountered in eight patients. Thrombosis was the most frequent complication and was reported in six out of eight patients. Time of thrombosis occurrence varied from 1 to 132 days with an average of 37 days. No statistically significant association was found between thrombosis of the PICC and any of the evaluated factors listed above but we found a trend toward a higher rate of thrombosis in hematological cancer patients compared to solid tumor patients (26% v/s 4%). Conclusions: Venous thrombosis complicating PICCs was reported in 13.7% of our oncology patients which represents a similar rate compared to the literature. However, the small number of recruited patients limits any conclusion and warrants more patients to be enrolled with a longer follow-up period.