Medical Oncology Department, IMIB, Hospital Universitario Morales Meseguer, Universidad de Murcia, Murcia, Spain.
Medical Oncology Department, Hospital Clínico Universitario Virgen de La Arrixaca, El Palmar, Spain.
Clin Transl Oncol. 2024 Dec;26(12):3226-3235. doi: 10.1007/s12094-024-03548-8. Epub 2024 Jun 12.
Peripherally inserted central venous catheters (PICC) in the onco-hematological patients may be associated with thrombosis or infections that may have short- to medium-term repercussions.
Single-centre retrospective analysis of a prospectively collected cohort. Primary objective was to establish the PICC-thrombosis and infections incidence. Secondary objectives were to analyze profile of patients suffering from these complications and variables associated with an increased likelihood of developing these events.
549 patients were recruited. 58.5% (n = 321) were oncology patients and 41.5% (n = 228) hematology patients. The incidence of PICC-associated thrombosis was 3.5% (n = 19). Thrombosis was associated with progression of the underlying malignant pathology in 10.6% (n = 2) of cases. No association was found between clinical variables analysed and development of thrombosis. Incidence of PICC-associated infections was 7.65% (n = 42). In the 30 days prior to PICC infection, 57.1% (n = 24) had a febrile syndrome of another focus, 73.8% (n = 11) had been hospitalized, 49.5% (n = 25) had a neutrophil count of 0-500 cells/mm3 and 47.6% (n = 20) had an episode of neutropenic fever. Variables significantly associated with the development of infection were hematological patients, high-flow PICC, 3-lm PICC or PICC insertion because of administration of vesicant therapy.
Incidence of PICC-associated thrombosis is low and apparently less prognostically aggressive than other forms of thrombosis associated with cancer, without identify predictive factors. Infection was more prevalent and the identification of risk factors in our series could facilitate its prevention.
肿瘤血液病患者的外周中心静脉置管（PICC）可能与血栓形成或感染有关，这些并发症可能会产生短期至中期的影响。
对前瞻性收集的队列进行单中心回顾性分析。主要目的是确定 PICC 相关血栓形成和感染的发生率。次要目标是分析发生这些并发症的患者的特征以及与这些事件发生风险增加相关的变量。
共纳入 549 例患者，其中 58.5%（n=321）为肿瘤患者，41.5%（n=228）为血液学患者。PICC 相关血栓形成的发生率为 3.5%（n=19）。血栓形成与 10.6%（n=2）病例中恶性肿瘤进展相关。未发现分析的临床变量与血栓形成的发生之间存在相关性。PICC 相关感染的发生率为 7.65%（n=42）。在 PICC 感染前 30 天内，57.1%（n=24）有其他部位的发热综合征，73.8%（n=11）住院，49.5%（n=25）中性粒细胞计数为 0-500 个细胞/mm3，47.6%（n=20）有中性粒细胞减少性发热发作。与感染发生显著相关的变量包括血液学患者、高流量 PICC、3-ml PICC 或因给予刺激性治疗而插入 PICC。
PICC 相关血栓形成的发生率较低，且与癌症相关的其他形式的血栓形成相比，其预后侵袭性似乎较小，且无预测因素。感染更为普遍，我们系列中危险因素的确定有助于其预防。
