成人癌症患者导管相关血栓形成:一项前瞻性随机对照试验的二次分析。

IF 5.5 2区 医学 Q1 HEMATOLOGY
Greg Hapgood, Kate Hill, Satomi Okano, Emad Abro, David Looke, Glen Kennedy, Gilbert Pavilion, Rosita Van Kuilenburg, Alanna Geary, Warren Joubert, Melissa Eastgate, Mark Jones, Peter Mollee
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引用次数: 0

摘要

背景:导管相关血栓(CRT)是中心静脉通路装置(CVAD)的一种并发症。关于导管插入侧的重要性证据不一。患者的手部优势对 CRT 易感性的作用仍不确定:在一项前瞻性随机对照试验中,成年癌症患者被随机分配到优势侧或非优势侧插入 CVAD。该试验的主要终点是检查导管相关血流感染的发生率。方法:640 例 CVAD 被随机分配到优势侧(322 例)或非优势侧(318 例)插入。只有无症状患者接受了超声成像以评估CRT:患者年龄中位数为58岁,60%的患者患有血液恶性肿瘤,40%的患者患有实体瘤。使用的CVAD包括外周置入中心导管线(PICC)(67%)、隧道式CVAD(23%)或非隧道式CVAD(10%)。显性组与非显性组的 CRT 发生率分别为每 1000 管路日 0.65 例与 0.82 例(HR 1.2;95% CI 0.58-2.48,P=0.63)。左侧插入与右侧插入的 CRT 发生率无明显差异(HR 0.63;95% CI 0.30-1.32,P=0.22)。右侧插管者的 CRT 发生率低于左侧插管者(HR 0.29;95% CI 0.12-0.71,P=0.007):结论:CRT发生率与CVAD插入时患者的惯用侧、非惯用侧或插入侧无关。插入者手部优势的作用需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Catheter-related thrombosis in adults with cancer: a secondary analysis of a prospective randomized controlled trial.

Background: Catheter-related thrombosis (CRT) is a complication of central venous access devices (CVADs). Evidence is variable regarding the significance of the side of catheter insertion. The role of the patient's hand dominance in predisposition to CRT remains uncertain.

Objectives: In a prospective randomized controlled trial, adult cancer patients were randomly allocated to either dominant or nondominant side CVAD insertion. The primary endpoint of this trial examined the incidence of catheter-associated bloodstream infection. Here, we report the secondary endpoint of the incidence of CRT.

Methods: Six hundred forty CVADs were randomized to the dominant (n = 322) or nondominant (n = 318) side of insertion. Only symptomatic patients underwent ultrasound imaging to evaluate for CRT.

Results: The median patient age was 58 years, 60% of patients had hematologic malignancies and 40% had solid tumors. CVADs used were peripherally-inserted central catheter line (67%), tunneled CVAD (23%), or nontunneled CVAD (10%). The CRT incidence rate was 0.65 versus 0.82 per 1000 line days in the dominant versus nondominant group (hazard ratio [HR], 1.2; 95% CI, 0.58-2.48; P = .63). There was no significant difference in CRT incidence rate between left- and right-sided insertions (HR, 0.63; 95% CI, 0.30-1.32; P = .22). The CRT incidence rate was lower in right-handed versus left-handed line inserters (HR, 0.29; 95% CI, 0.12-0.71; P = .007).

Conclusion: The rate of CRT was not associated with whether CVAD insertion was on the patient's dominant or nondominant side or the side of insertion. The role of inserter hand dominance requires further investigation.

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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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