Risk associated with central catheters for malignant tumor patients: a systematic review and meta-analysis
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Yajuan Lv1,*, Yong Hou1,*, Bo Pan2,*, Yuwan Ma2,*, Paiyun Li2, Lili Yu1, Deguo Xu1, Juanjuan Song1, Heli Shang1, Hongyan Wang1 and Yuan Tian1
1Department of Radiation Oncology, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong, 250014, P.R. China
2Key Laboratory of Translational Research, Peking University Cancer Hospital and Institute, Beijing, 100142, China
*These authors contributed equally to this work
Yuan Tian, email: email@example.com
Keywords: central catheters; PICC; CICC; thrombosis; mortality
Received: October 26, 2017 Accepted: December 05, 2017 Published: January 12, 2018
The risk of venous thrombosis and mortality associated with central catheter (PICC/CICC) for malignant tumor patients is not definite. So, we carried out a systematic review and meta-analysis to evaluate it. Among patients with comparing PICC with CICC, odds ratio (OR) or risk ratio (RR) was calculated with a random effect model meta-analysis. The result of the stratification analysis of 7 studies (PICC vs CICC) supported the theory that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs. 7 of 15 studies provided the information about the compared mortality rate of the patients. The result showed that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs (OR = 0.45, 95% CI:0.32–0.62, p < 0.0001, I2 = 0%,Tau2 = 0.00). Meta-analysis of 8 studies of 2639 patients showed that pharmacological deep vein thrombosis prophylaxis drugs could decrease the risk of mortality of malignant tumor patients with CICCs (RR = 0.58, 95% CI:0.48–0.71, Z = 5.32, p < 0.0001, I2 = 71%). We found that PICCs are associated with a raised risk of deep vein thrombosis, and pharmacological deep vein thrombosis prophylaxis drugs is a beneficial factor in decreasing the incidence of thrombosis, while warfarin may decrease the risk of mortality of malignant tumor patients with CICCs.
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