Thromboprophylaxis in cancer patients with central venous catheters. A systematic review and meta-analysis

Pooja Chaukiyal, Amit Nautiyal, Sangeetha Radhakrishnan, Sonal Singh, Sankar D. Navaneethan

Research output: Contribution to journalArticle

Abstract

It was the aim of the review to determine the risks and benefits of primary thromboprophylaxis with anticoagulants in cancer patients with central venous devices. Medline, Central and Google Scholar databases were searched for randomized controlled trials (RCTs) in June 2006. Two reviewers extracted data and appraised the quality of RCTs. Results were expressed as relative risk (RR) with 95% confidence intervals (CI) using random effects model for the outcomes of catheter-related thrombosis, bleeding and thrombocytopenia. Eight RCTs (1,428 patients) were included.There was no statistically significant difference in the risk of catheter-related thrombosis for the use of warfarin versus placebo (3 trials, 425 patients, RR 0.75, 95% CI 0.24-2.35, p=0.63), heparin versus placebo (4 trials,886 patients, RR 0.46 95% CI 0.18-1.20, p=0.06) or warfarin, unfractionated heparin or low-molecular-weight heparin versus placebo (7 trials, 1,311 patients, RR 0.59, 95% CI 0.31-1.13, p=0.11). Substantial statistical heterogeneity was noted among these trials (I2>50%).The use of anticoagulants showed no statistically significant difference in the risk of overall bleeding (5 trials, 1,193 patients, RR 1.24, 95% CI 0.84-1.82, p=0.28), and thrombocytopenia for heparin versus placebo (4 trials, 958 patients, RR 0.85,95% CI 0.49,1.46, p=0.55) without any statistical heterogeneity (I2=0%). In cancer patients with central venous devices, thromboprophylaxis has no significant effect on the risk of catheter related thrombosis or bleeding. The use of primary thromboprophylaxis in cancer patients with central venous catheters while not causing any harm provides no benefit.

Original languageEnglish (US)
Pages (from-to)38-43
Number of pages6
JournalThrombosis and Haemostasis
Volume99
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Fingerprint

Central Venous Catheters
Meta-Analysis
Confidence Intervals
Neoplasms
Placebos
Heparin
Thrombosis
Catheters
Randomized Controlled Trials
Warfarin
Hemorrhage
Thrombocytopenia
Anticoagulants
Equipment and Supplies
Low Molecular Weight Heparin
Databases

Keywords

  • Cancer
  • Catheter-related thrombosis
  • Thromboprophylaxis

ASJC Scopus subject areas

  • Hematology

Cite this

Thromboprophylaxis in cancer patients with central venous catheters. A systematic review and meta-analysis. / Chaukiyal, Pooja; Nautiyal, Amit; Radhakrishnan, Sangeetha; Singh, Sonal; Navaneethan, Sankar D.

In: Thrombosis and Haemostasis, Vol. 99, No. 1, 01.2008, p. 38-43.

Research output: Contribution to journalArticle

Chaukiyal, Pooja ; Nautiyal, Amit ; Radhakrishnan, Sangeetha ; Singh, Sonal ; Navaneethan, Sankar D. / Thromboprophylaxis in cancer patients with central venous catheters. A systematic review and meta-analysis. In: Thrombosis and Haemostasis. 2008 ; Vol. 99, No. 1. pp. 38-43.
@article{39821f5a794b4bf18355e23a4e5272d4,
title = "Thromboprophylaxis in cancer patients with central venous catheters. A systematic review and meta-analysis",
abstract = "It was the aim of the review to determine the risks and benefits of primary thromboprophylaxis with anticoagulants in cancer patients with central venous devices. Medline, Central and Google Scholar databases were searched for randomized controlled trials (RCTs) in June 2006. Two reviewers extracted data and appraised the quality of RCTs. Results were expressed as relative risk (RR) with 95{\%} confidence intervals (CI) using random effects model for the outcomes of catheter-related thrombosis, bleeding and thrombocytopenia. Eight RCTs (1,428 patients) were included.There was no statistically significant difference in the risk of catheter-related thrombosis for the use of warfarin versus placebo (3 trials, 425 patients, RR 0.75, 95{\%} CI 0.24-2.35, p=0.63), heparin versus placebo (4 trials,886 patients, RR 0.46 95{\%} CI 0.18-1.20, p=0.06) or warfarin, unfractionated heparin or low-molecular-weight heparin versus placebo (7 trials, 1,311 patients, RR 0.59, 95{\%} CI 0.31-1.13, p=0.11). Substantial statistical heterogeneity was noted among these trials (I2>50{\%}).The use of anticoagulants showed no statistically significant difference in the risk of overall bleeding (5 trials, 1,193 patients, RR 1.24, 95{\%} CI 0.84-1.82, p=0.28), and thrombocytopenia for heparin versus placebo (4 trials, 958 patients, RR 0.85,95{\%} CI 0.49,1.46, p=0.55) without any statistical heterogeneity (I2=0{\%}). In cancer patients with central venous devices, thromboprophylaxis has no significant effect on the risk of catheter related thrombosis or bleeding. The use of primary thromboprophylaxis in cancer patients with central venous catheters while not causing any harm provides no benefit.",
keywords = "Cancer, Catheter-related thrombosis, Thromboprophylaxis",
author = "Pooja Chaukiyal and Amit Nautiyal and Sangeetha Radhakrishnan and Sonal Singh and Navaneethan, {Sankar D.}",
year = "2008",
month = "1",
doi = "10.1160/TH07-07-0446",
language = "English (US)",
volume = "99",
pages = "38--43",
journal = "Thrombosis and Haemostasis",
issn = "0340-6245",
publisher = "Schattauer GmbH",
number = "1",

}

TY - JOUR

T1 - Thromboprophylaxis in cancer patients with central venous catheters. A systematic review and meta-analysis

AU - Chaukiyal, Pooja

AU - Nautiyal, Amit

AU - Radhakrishnan, Sangeetha

AU - Singh, Sonal

AU - Navaneethan, Sankar D.

PY - 2008/1

Y1 - 2008/1

N2 - It was the aim of the review to determine the risks and benefits of primary thromboprophylaxis with anticoagulants in cancer patients with central venous devices. Medline, Central and Google Scholar databases were searched for randomized controlled trials (RCTs) in June 2006. Two reviewers extracted data and appraised the quality of RCTs. Results were expressed as relative risk (RR) with 95% confidence intervals (CI) using random effects model for the outcomes of catheter-related thrombosis, bleeding and thrombocytopenia. Eight RCTs (1,428 patients) were included.There was no statistically significant difference in the risk of catheter-related thrombosis for the use of warfarin versus placebo (3 trials, 425 patients, RR 0.75, 95% CI 0.24-2.35, p=0.63), heparin versus placebo (4 trials,886 patients, RR 0.46 95% CI 0.18-1.20, p=0.06) or warfarin, unfractionated heparin or low-molecular-weight heparin versus placebo (7 trials, 1,311 patients, RR 0.59, 95% CI 0.31-1.13, p=0.11). Substantial statistical heterogeneity was noted among these trials (I2>50%).The use of anticoagulants showed no statistically significant difference in the risk of overall bleeding (5 trials, 1,193 patients, RR 1.24, 95% CI 0.84-1.82, p=0.28), and thrombocytopenia for heparin versus placebo (4 trials, 958 patients, RR 0.85,95% CI 0.49,1.46, p=0.55) without any statistical heterogeneity (I2=0%). In cancer patients with central venous devices, thromboprophylaxis has no significant effect on the risk of catheter related thrombosis or bleeding. The use of primary thromboprophylaxis in cancer patients with central venous catheters while not causing any harm provides no benefit.

AB - It was the aim of the review to determine the risks and benefits of primary thromboprophylaxis with anticoagulants in cancer patients with central venous devices. Medline, Central and Google Scholar databases were searched for randomized controlled trials (RCTs) in June 2006. Two reviewers extracted data and appraised the quality of RCTs. Results were expressed as relative risk (RR) with 95% confidence intervals (CI) using random effects model for the outcomes of catheter-related thrombosis, bleeding and thrombocytopenia. Eight RCTs (1,428 patients) were included.There was no statistically significant difference in the risk of catheter-related thrombosis for the use of warfarin versus placebo (3 trials, 425 patients, RR 0.75, 95% CI 0.24-2.35, p=0.63), heparin versus placebo (4 trials,886 patients, RR 0.46 95% CI 0.18-1.20, p=0.06) or warfarin, unfractionated heparin or low-molecular-weight heparin versus placebo (7 trials, 1,311 patients, RR 0.59, 95% CI 0.31-1.13, p=0.11). Substantial statistical heterogeneity was noted among these trials (I2>50%).The use of anticoagulants showed no statistically significant difference in the risk of overall bleeding (5 trials, 1,193 patients, RR 1.24, 95% CI 0.84-1.82, p=0.28), and thrombocytopenia for heparin versus placebo (4 trials, 958 patients, RR 0.85,95% CI 0.49,1.46, p=0.55) without any statistical heterogeneity (I2=0%). In cancer patients with central venous devices, thromboprophylaxis has no significant effect on the risk of catheter related thrombosis or bleeding. The use of primary thromboprophylaxis in cancer patients with central venous catheters while not causing any harm provides no benefit.

KW - Cancer

KW - Catheter-related thrombosis

KW - Thromboprophylaxis

UR - http://www.scopus.com/inward/record.url?scp=38349104201&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38349104201&partnerID=8YFLogxK

U2 - 10.1160/TH07-07-0446

DO - 10.1160/TH07-07-0446

M3 - Article

VL - 99

SP - 38

EP - 43

JO - Thrombosis and Haemostasis

JF - Thrombosis and Haemostasis

SN - 0340-6245

IS - 1

ER -