Risk associated with central catheters for malignant tumor patients: a systematic review and meta-analysis

// Yajuan Lv 1, * , Yong Hou 1, * , Bo Pan 2, * , Yuwan Ma 2, * , Paiyun Li 2 , Lili Yu 1 , Deguo Xu 1 , Juanjuan Song 1 , Heli Shang 1 , Hongyan Wang 1 and Yuan Tian 1 1 Department of Radiation Oncology, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong, 250014, P.R. China 2 Key Laboratory of Translational Research, Peking University Cancer Hospital and Institute, Beijing, 100142, China * These authors contributed equally to this work Correspondence to: Yuan Tian, email: tytytianyuan@aliyun.com Keywords: central catheters; PICC; CICC; thrombosis; mortality Received: October 26, 2017      Accepted: December 05, 2017      Published: January 12, 2018 ABSTRACT 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, I 2 = 0%,Tau 2 = 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, I 2 = 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.