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Anticoagulants decrease the risk for catheter-related venous thrombosis in patients with chronic intestinal failure:
Veerle E L M Gillis1, Thijs van Houdt1, Yannick Wouters1
1Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
JPEN. Journal of Parenteral and Enteral Nutrition
|December 30, 2021
Summary
Anticoagulants reduced catheter-related venous thrombosis (CRVT) risk in patients with chronic intestinal failure (CIF). Key risk factors include left-sided catheter insertion and prior venous thrombosis history.
Area of Science:
- Vascular Medicine
- Thrombosis Research
- Parenteral Nutrition
Background:
- Catheter-related venous thrombosis (CRVT) is a serious complication of home parenteral nutrition.
- Current guidelines lack consensus on anticoagulant prophylaxis for CRVT prevention.
Purpose of the Study:
- To evaluate the impact of anticoagulants on CRVT risk in patients with chronic intestinal failure (CIF).
- To identify independent risk factors for CRVT in this patient population.
Main Methods:
- Retrospective cohort study of adult CIF patients with central venous access devices (CVADs) from 2010-2020.
- Analysis of 1188 CVADs in 389 patients, comparing CRVT incidence with and without anticoagulant use.
Main Results:
- Anticoagulant use was associated with a significantly decreased CRVT risk (OR=0.53, P=0.02).
- Independent risk factors for CRVT included left-sided CVAD insertion (OR=2.00), history of venous thrombosis (OR=1.73), and shorter duration post-CVAD insertion (OR=0.78).
Conclusions:
- Anticoagulants demonstrate a protective effect against CRVT in CIF patients.
- Left-sided CVAD insertion, prior venous thrombosis, and shorter post-insertion periods are significant CRVT risk factors.
- Further prospective research is warranted to guide prophylactic anticoagulant use in high-risk patients.
Keywords:
anticoagulantscatheter-related venous thrombosischronic intestinal failurehome parental nutritionpreventionthrombosisMore Related Videos
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