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Risk factors for subclavian vein thrombosis in cancer patients with total parenteral nutrition.

Berea-Baltierra R, Rivas-Ruiz R, Vela-Martinez E, Sevilla-Gonzalez Mde L, Talavera-Pina JO, Valencia-Jimenez E, Perez-Franco I, Escobedo-Hernandez L - J Clin Med Res (2014)

Bottom Line: Fifty-three point three percent of patients receiving ≥ 3,050 mOsm TPN in 24 hours developed SVT (relative risk (RR) = 2.01, 95% CI, 1.14 - 3.57; P = 0.016) at day 8 and 60% (RR = 1.67, 95% CI, 1.30 - 2.71; P = 0.038) at day 30 post-catheter placement.Protein administration of > 97.5 g/day was shown to be a risk factor for early thrombosis with a mean of 16.88 days for the development of SVT (95% CI, 10 - 23.7) versus 27.8 days (95% CI, 25.8 - 29.9) in the group with nutritional protein content < 97.5 g/day (P = 0.000).High-osmolarity and high-protein nutrition formulas were shown to be risk factors for SVT in cancer patients receiving TPN.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine and Nutritional Support, Oncology Hospital, Centro Medico Nacional Siglo XXI, Mexico City, Mexico.

ABSTRACT

Background: There are few reports on total parenteral nutrition (TPN) and its possible prothrombotic effect. The purpose of this study was to identify risk factors for subclavian vein thrombosis (SVT) in patients receiving TPN.

Method: Cancer patients with indwelling subclavian catheters and TPN were followed in a cohort study. Doppler ultrasound examination was performed 8 and 30 days after catheter placement.

Results: One hundred twenty-one patients were included, with a mean of 61 (± 11.8) years of age. We detected 36 SVT events at day 8 (29.8%) and 47 (38.8%) at day 30 after central catheter placement. Mean length of subclavian catheterization was 17.2 (± 8.2) days. Fifty-three point three percent of patients receiving ≥ 3,050 mOsm TPN in 24 hours developed SVT (relative risk (RR) = 2.01, 95% CI, 1.14 - 3.57; P = 0.016) at day 8 and 60% (RR = 1.67, 95% CI, 1.30 - 2.71; P = 0.038) at day 30 post-catheter placement. Protein administration of > 97.5 g/day was shown to be a risk factor for early thrombosis with a mean of 16.88 days for the development of SVT (95% CI, 10 - 23.7) versus 27.8 days (95% CI, 25.8 - 29.9) in the group with nutritional protein content < 97.5 g/day (P = 0.000).

Conclusion: High-osmolarity and high-protein nutrition formulas were shown to be risk factors for SVT in cancer patients receiving TPN.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier plot. Subclavian vein thrombosis in patients with fibrinogen > 550 mg/dL according to protein administration in daily TPN.
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Figure 3: Kaplan-Meier plot. Subclavian vein thrombosis in patients with fibrinogen > 550 mg/dL according to protein administration in daily TPN.

Mentions: A Kaplan-Meier curve was plotted to analyze the independent variables without the possible bias of normal to low fibrinogen levels. Protein administration of 97.5 g/day or more showed an effect on the risk of thrombosis in patients with high fibrinogen levels (> 550 mg/dL), with a mean of 16.88 days to develop thrombosis (95% CI, 10 - 23.7) versus 27.8 days (95% CI, 25.8 - 29.9) in the group with < 97.5 g/day nutritional protein content, (P = 0.000) (Fig. 3).


Risk factors for subclavian vein thrombosis in cancer patients with total parenteral nutrition.

Berea-Baltierra R, Rivas-Ruiz R, Vela-Martinez E, Sevilla-Gonzalez Mde L, Talavera-Pina JO, Valencia-Jimenez E, Perez-Franco I, Escobedo-Hernandez L - J Clin Med Res (2014)

Kaplan-Meier plot. Subclavian vein thrombosis in patients with fibrinogen > 550 mg/dL according to protein administration in daily TPN.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125329&req=5

Figure 3: Kaplan-Meier plot. Subclavian vein thrombosis in patients with fibrinogen > 550 mg/dL according to protein administration in daily TPN.
Mentions: A Kaplan-Meier curve was plotted to analyze the independent variables without the possible bias of normal to low fibrinogen levels. Protein administration of 97.5 g/day or more showed an effect on the risk of thrombosis in patients with high fibrinogen levels (> 550 mg/dL), with a mean of 16.88 days to develop thrombosis (95% CI, 10 - 23.7) versus 27.8 days (95% CI, 25.8 - 29.9) in the group with < 97.5 g/day nutritional protein content, (P = 0.000) (Fig. 3).

Bottom Line: Fifty-three point three percent of patients receiving ≥ 3,050 mOsm TPN in 24 hours developed SVT (relative risk (RR) = 2.01, 95% CI, 1.14 - 3.57; P = 0.016) at day 8 and 60% (RR = 1.67, 95% CI, 1.30 - 2.71; P = 0.038) at day 30 post-catheter placement.Protein administration of > 97.5 g/day was shown to be a risk factor for early thrombosis with a mean of 16.88 days for the development of SVT (95% CI, 10 - 23.7) versus 27.8 days (95% CI, 25.8 - 29.9) in the group with nutritional protein content < 97.5 g/day (P = 0.000).High-osmolarity and high-protein nutrition formulas were shown to be risk factors for SVT in cancer patients receiving TPN.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine and Nutritional Support, Oncology Hospital, Centro Medico Nacional Siglo XXI, Mexico City, Mexico.

ABSTRACT

Background: There are few reports on total parenteral nutrition (TPN) and its possible prothrombotic effect. The purpose of this study was to identify risk factors for subclavian vein thrombosis (SVT) in patients receiving TPN.

Method: Cancer patients with indwelling subclavian catheters and TPN were followed in a cohort study. Doppler ultrasound examination was performed 8 and 30 days after catheter placement.

Results: One hundred twenty-one patients were included, with a mean of 61 (± 11.8) years of age. We detected 36 SVT events at day 8 (29.8%) and 47 (38.8%) at day 30 after central catheter placement. Mean length of subclavian catheterization was 17.2 (± 8.2) days. Fifty-three point three percent of patients receiving ≥ 3,050 mOsm TPN in 24 hours developed SVT (relative risk (RR) = 2.01, 95% CI, 1.14 - 3.57; P = 0.016) at day 8 and 60% (RR = 1.67, 95% CI, 1.30 - 2.71; P = 0.038) at day 30 post-catheter placement. Protein administration of > 97.5 g/day was shown to be a risk factor for early thrombosis with a mean of 16.88 days for the development of SVT (95% CI, 10 - 23.7) versus 27.8 days (95% CI, 25.8 - 29.9) in the group with nutritional protein content < 97.5 g/day (P = 0.000).

Conclusion: High-osmolarity and high-protein nutrition formulas were shown to be risk factors for SVT in cancer patients receiving TPN.

No MeSH data available.


Related in: MedlinePlus