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A systematic review of patient-related risk factors for catheter-related thrombosis
Amy Leung1, Clare Heal, Marlon Perera
1School of Medicine and Dentistry, James Cook University, Mackay Base Hospital, 475 Bridge Road, Mackay, QLD, 4650, Australia, amy.leung@my.jcu.edu.au.
Insights
Identifying patient risk factors for catheter-related thrombosis is crucial. While age, malignancy, and diabetes were noted, consistent associations remain elusive, necessitating further research.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Medical Device Complications
Background:
- Central venous catheters (CVC) and peripherally inserted central catheters (PICC) are essential but increase venous thrombosis risk.
- Patient-related factors influencing this risk require clear identification for preventative strategies.
Purpose of the Study:
- To systematically review and identify patient-related risk factors for venous thrombosis in individuals with CVC or PICC.
- To synthesize current evidence on associations between patient characteristics and catheter-related thrombosis.
Main Methods:
- Systematic literature review of observational studies from PubMed, Ovid, and Cochrane Library.
- Inclusion criteria focused on patient-related risk factors for CVC/PICC-related thrombosis.
- Twenty-five studies were selected to evaluate 20 potential risk factors.
Main Results:
- No consistent, significant associations were found across studies for most patient-related risk factors.
- Age, malignancy, diabetes, obesity, chemotherapy, thrombophilia, and prior thrombosis were frequently cited but inconsistently significant.
- Inconsistent findings highlight challenges in establishing definitive risk factor profiles.
Conclusions:
- Current evidence is insufficient to definitively establish key patient-related risk factors for catheter-related thrombosis.
- Larger studies with higher event rates are needed to yield more significant and reliable results.
- Identifying these factors is vital for early detection and prevention of upper limb deep vein thrombosis in catheterized patients.
Abstract:
To identify patient-related risk factors for venous thrombosis in patients with central venous catheters (CVC) or peripherally inserted central catheters (PICC). We performed a systematic review of the literature assessing patient-related risk factors for thrombosis related to CVC or PICC. The databases PubMed, Ovid and the Cochrane library were searched for observational studies pertaining to patient-related risk factors for CVC and PICC-related thrombosis. The initial search through PubMed, Ovid and the Cochrane library yielded 516 results. After 71 duplicates were removed, 445 articles were assessed for eligibility based on title and abstract. Four hundred and eleven articles were then excluded and 33 full text articles were manually assessed for eligibility. Eight articles were eliminated as they did not contain content relevant to the review. Twenty-five studies were then selected to assess 20 risk factors. There were no consistent significant associations for catheter-related thrombosis across the twenty-five studies. Multiple studies identified age, malignancy, diabetes, obesity, chemotherapy, thrombophilia and a history of thrombosis as significant risk factors for catheter-related thrombosis. Inconsistent findings among studies make it difficult to establish which patient-related risk factors are associated with catheter-related thrombosis. Future studies could include larger sample sizes and more cases of catheter-related thrombosis to produce more significant results. Identification of patient-related risk factors could lead to early recognition of upper limb deep vein thrombosis in patients with catheters, thereby preventing complications.
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