Risk Factors Of Venous Access Ports-Catheter Related Thrombosis In Breast Cancer Patients

Objectives The main purpose of our study is to observe the incidence and identify risk factors of catheter-related thrombosis in breast cancer patients with venous access ports(VAP-CRT).In order to evaluate the risk of VAP-CRT in breast cancer patients and provide the basis for developing preventive measures.Methods We performed a retrospective cohort study of breast cancer patients who received the VAP implantation for the administration of chemotherapy in Hebei General Hospital from June 2019 to June 2021.All breast cancer patients who received a VAP for chemotherapy were retrieved.It consisted of 517 breast cancer patients with a implanted VAP for chemotherapy,with 216 patients did not check cervical vascular color doppler ultrasound or upper limb deep vein color ultrasound,with 95 patients were stage IV breast cancer,with 7 patients were combined with multiple primary carcinomas,with 60 patients were still during chemotherapy,with 5 patients were multiply punctured.After excluding the patients who did not meet the criteria,a total of 134 breast cancer patients undergoing surgery and chemotherapy with a implanted VAP were included in this study.We collected patient-related clinical data and summarized the relevant indicators that may affect the formation of VAP-CRT.Univariable and multivariable Logistic regression analyses through SPSS26 software were used to identify the risk factors for breast cancer VAP related CRT.Results 1 The enrolled 134 patients,56 patients had VAP-CRT after completion of chemotherapy,8 patients were symptomatic,the other 48 patients were asymptomatic.The incidence of VAP-CRT in breast cancer patients was 41.8%.The incidence of symptomatic VAP-CRT was 6.0%.The incidence of asymptomatic VAP-CRT was35.8%.2 In the univariate analysis,age,BMI,hypercoagulative state,TNM stage of primary breast cancer was associated with breast cancer VAP-CRT(P<0.05).However,hypertension,diabetes,coronary disease,antiplatelet therapy,a history of atrial fibrillation,port location(basilic vein,jugular vein),molecular subtyping of breast cancer(Luminal A,Luminal B,Her2,triple negative breast cancer),leukocyte,neutrophil lymphocyte ratio,hemoglobin were not associated with VAP-CRT(P>0.05).3 In the multivariate analysis,age,body mass index(BMI),hypercoagulative state,TNM stage of primary breast cancer were the significant independent risk factors of breast cancer VAPCRT(P<0.05).Patients older than 60 had a nearly 2.778-fold increased risk of VAP-CRT compared to those younger than 60 [OR=3.778(95%CI: 1.514-9.429),P=0.004];Patients with a BMI greater than 28 had a 3.547-fold increased risk of VAP-CRT compared with patients with a normal BMI [OR=4.547(95%CI: 1.477-13.997),P=0.008];Patients who combined with hypercoagulation status had a nearly 2.064-fold increased risk of VAP-CRT compared with those in non-hypercoagulation patients[OR=3.064(95%CI: 1.335-7.030),P=0.008];Patients with TNM stages Ⅲ of breast cancer had a nearly 3.954-fold increased risk of VAP-CRT compared with those in patients with stage I.[OR=4.954(95%CI: 1.423-17.250),P=0.012].Conclusions 1 VAP-CRT was highly occurred in breast cancer patients with a implanted VAP for chemotherapy.The incidence of asymptomatic VAP-CRT was higher than that of symptomatic VAP-CRT.2 Age,BMI,hypercoagulative state,TNM stage of primary breast cancer were the significant independent risk factors of breast cancer VAP-CRT.Figure0;Table15;Reference 256...