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Curtis K, Gough K, Krishnasamy M, Tarasenko E, Hill G, Keogh S. Central venous access device terminologies, complications, and reason for removal in oncology: a scoping review. BMC Cancer 2024; 24:498. [PMID: 38641574 PMCID: PMC11027380 DOI: 10.1186/s12885-024-12099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/08/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Lack of agreed terminology and definitions in healthcare compromises communication, patient safety, optimal management of adverse events, and research progress. The purpose of this scoping review was to understand the terminologies used to describe central venous access devices (CVADs), associated complications and reasons for premature removal in people undergoing cancer treatment. It also sought to identify the definitional sources for complications and premature removal reasons. The objective was to map language and descriptions used and to explore opportunities for standardisation. METHODS A systematic search of MedLine, PubMed, Cochrane, CINAHL Complete and Embase databases was performed. Eligibility criteria included, but were not limited to, adult patients with cancer, and studies published between 2017 and 2022. Articles were screened and data extracted in Covidence. Data charting included study characteristics and detailed information on CVADs including terminologies and definitional sources for complications and premature removal reasons. Descriptive statistics, tables and bar graphs were used to summarise charted data. RESULTS From a total of 2363 potentially eligible studies, 292 were included in the review. Most were observational studies (n = 174/60%). A total of 213 unique descriptors were used to refer to CVADs, with all reasons for premature CVAD removal defined in 84 (44%) of the 193 studies only, and complications defined in 56 (57%) of the 292 studies. Where available, definitions were author-derived and/or from national resources and/or other published studies. CONCLUSION Substantial variation in CVAD terminology and a lack of standard definitions for associated complications and premature removal reasons was identified. This scoping review demonstrates the need to standardise CVAD nomenclature to enhance communication between healthcare professionals as patients undergoing cancer treatment transition between acute and long-term care, to enhance patient safety and rigor of research protocols, and improve the capacity for data sharing.
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Affiliation(s)
- Kerrie Curtis
- Department of Nursing, University of Melbourne, Melbourne, Australia.
- Peter MacCallum Cancer Centre, Melbourne, Australia.
- Austin Health, Melbourne, Australia.
| | - Karla Gough
- Department of Nursing, University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Meinir Krishnasamy
- Department of Nursing, University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre Alliance, Melbourne, Australia
| | | | - Geoff Hill
- Royal Melbourne Hospital, Melbourne, Australia
| | - Samantha Keogh
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
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Duggan C, Hernon O, Dunne R, McInerney V, Walsh SR, Lowery A, McCarthy M, Carr PJ. Vascular access device type for systemic anti-cancer therapies in cancer patients: A scoping review. Crit Rev Oncol Hematol 2024; 196:104277. [PMID: 38492760 DOI: 10.1016/j.critrevonc.2024.104277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Patients with cancer can expect to receive numerous invasive vascular access procedures for intravenous therapy and clinical diagnostics. Due to the increased incidence and prevalence of cancer globally there will be significantly more people who require first-line intravenous chemotherapy over the next ten years. METHODS Our objective was to determine the types of evidence that exist for the vascular access device (VAD) type for the delivery of systemic anti-cancer therapy (SACT) in cancer patients. We used JBI scoping review methodology to identify the types of VADs used for SACT and with a specific search strategy included articles from 2012-2022 published in the English language. We identify (i) type of VADs used for SACT delivery (ii) the type of insertion and post-insertion complications (iii) the geographical location and clinical environment (iv) and whether VAD choice impacts on quality of life (QOL). Findings were presented using the PAGER framework. MAIN FINDINGS Our search strategy identified 10,390 titles, of these, 5318 duplicates were removed. The remaining 5072 sources were screened for eligibility, 240 articles met the inclusion criteria. The most common design include retrospective study designs (n = 91) followed by prospective study designs (n = 31). We found 28 interventional studies with 21 registered in a clinical trial registry and identified no core outcome sets papers specific to VAD for SACT. The most prevalent publications were those that featured two or more VAD types (n = 70), followed by tunnelled intravenous VADs (n = 67). Of 38 unique complications identified, the most frequent catheter related complication was catheter related thrombosis (n = 178, 74%), followed by infection (n = 170, 71%). The county where the most publications originated from was China (n = 62) with one randomized controlled multicenter study from a comprehensive cancer centre. Of the thirty three studies that included QOL we found 4 which reported on body image. No QOL measurement tools specific to the process of SACT administration via VAD are available INTERPRETATION: Our findings suggest a systematic review and meta-analysis of VAD use for intravenous SACT can be considered. However, the development of a core outcome set for SACT should be prioritised. Funding for high quality programs of research for VAD in cancer are needed. Comprehensive cancer centres should lead this research agenda.
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Affiliation(s)
- C Duggan
- Department of Oncology, Portiuncula Hospital, Ballinasloe, Galway H53 T971, Ireland; School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia.
| | - O Hernon
- School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia
| | - R Dunne
- Library, University of Galway, Ireland
| | - V McInerney
- HRB Clinical Research Facility, University of Galway, Ireland
| | - S R Walsh
- Department of Vascular Surgery, Galway University Hospital, Ireland
| | - A Lowery
- School of Medicine, University of Galway, Ireland
| | - M McCarthy
- Department of Medical Oncology, Galway University Hospital, Ireland
| | - P J Carr
- School of Nursing and Midwifery, University of Galway, Ireland; Alliance for Vascular Access Teaching and Research (AVATAR) Group, Queensland, Australia
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Chen L, Lu Y, Wang L, Pan Y, Zhou X. Construction of a nomogram risk prediction model for PICC-related venous thrombosis and its application. Asian J Surg 2024; 47:107-111. [PMID: 37302889 DOI: 10.1016/j.asjsur.2023.05.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/07/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE To explore the risk factors of the peripherally inserted central catheter (PICC)-related venous thrombosis and correspondingly construct a nomogram risk prediction model. METHODS The clinical data of 401 patients receiving PICC catheterization in our hospital from June 2019 to June 2022 were retrospectively analyzed. The independent influencing factors for venous thrombosis were predicted using logistic regression analysis, and significant indicators were screened to construct a nomogram for predicting PICC-related venous thrombosis. The difference in predictive efficacy between simple clinical data and nomogram was analyzed using a receiver operating characteristic (ROC) curve, and the nomogram was internally validated. RESULTS Single-factor analysis showed that catheter tip position, plasma D-dimer concentration, venous compression, malignant tumor, diabetes, history of thrombosis, history of chemotherapy, and history of PICC/CVC catheterization were correlated with PICC-related venous thrombosis. Further multi-factor analysis revealed that catheter tip position, plasma D-dimer elevation, venous compression, history of thrombosis and history of PICC/CVC catheterization were the risk factors for PICC-related venous thrombosis. Based on binary logistic regression analysis, a nomogram prediction model for PICC-related venous thrombosis was constructed. The area under the curve (AUC) was 0.876 (95%CI: 0.818-0.925), with a statistically significant difference (P < 0.01). CONCLUSION The independent risk factors for PICC-related venous thrombosis are screened out, including catheter tip position, plasma D-dimer elevation, venous compression, history of thrombosis and history of PICC/CVC catheterization, and a nomogram prediction model with good effect is constructed to predict the risk of PICC-related venous thrombosis.
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Affiliation(s)
- Lili Chen
- Department of Traditional Chinese Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yanyan Lu
- Department of Vascular Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Lei Wang
- Department of PICC Catheter Maintenance Clinic, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yihong Pan
- Department of Traditional Chinese Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Xiaoyan Zhou
- Department of Traditional Chinese Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China.
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Fu J, Zhao L, Tian Y, Liu Y, Zhang H, Li H. Impact of terminal tip location of midline catheters on catheter-related complications and indwelling duration in elderly patients. Nurs Open 2023; 10:2349-2356. [PMID: 36385582 PMCID: PMC10006645 DOI: 10.1002/nop2.1490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 09/21/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
AIM To investigate the relationship between the position of the midline catheter tip and the frequency and type of complications associated with its placement. DESIGN A cohort study was performed on patients between May 2018 and December 2021 who underwent midline catheter placement at our institution. Patients were divided into two groups, superficial implementation and deep implementation, based on the midline catheter tip location relative to the clavicle. METHODS Clinical data and outcome parameters, including the numbers and types of midline catheter-related complications, day of occurrence and catheter indwell duration, were recorded. RESULTS Catheter-related complications occurred in 14 individuals. Compared with the superficial implementation group, the incidence of complications in the deep catheterization group was significantly reduced, with a delayed first occurrence time, and a prolonged catheter indwelling time. The results suggested that locating the midline catheter tip in the distal segment of the axillary vein may reduce catheter-related complication incidence and prolong the indwelling duration.
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Affiliation(s)
- Jing Fu
- Department of Geriatrics & The Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Nursing Theory & Practice Innovation Research Center of Shandong University, Jinan, China
| | - Lingling Zhao
- Nursing Theory & Practice Innovation Research Center of Shandong University, Jinan, China.,Department of Nursing, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Yingmei Tian
- Department of Geriatrics & The Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Nursing Theory & Practice Innovation Research Center of Shandong University, Jinan, China
| | - Yinmeng Liu
- Department of Geriatrics & The Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Nursing Theory & Practice Innovation Research Center of Shandong University, Jinan, China
| | - Hongyu Zhang
- Department of Geriatrics & The Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Haijun Li
- Department of Geriatrics & The Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
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Luo H, Jin C, Li X, Jiang Y, Zhou J. Quantified versus willful handgrip exercises for the prevention of PICC-related thrombosis: A meta-analysis and systematic review. Medicine (Baltimore) 2023; 102:e32706. [PMID: 36897677 PMCID: PMC9997825 DOI: 10.1097/md.0000000000032706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/29/2022] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Thrombosis is a common yet serious complication in patients with peripherally inserted central venous catheter (PICC), the prevention of thrombosis is very important to the prognosis of PICC patients. We aimed to evaluate the effects of quantified versus willful grip exercises for the prevention of PICC-related thrombosis, to provide evidence to the clinical nursing care of PICC patients. METHODS Two authors searched PubMed et al databases for randomized controlled trials (RCTs) comparing the effects of quantified versus willful grip exercises in PICC patients up to August 31, 2022. Quality assessment and data extraction were independently performed by 2 researchers, and meta-analysis was performed using RevMan 5.3 software. RESULTS 15 RCTs involving 1741 PICC patients were finally included in this meta-analysis. Synthesized outcomes indicated that compared with willful grip exercises, quantified grip exercises reduced the incidence of PICC-related thrombosis (odds ratio = 0.19, 95% confidence interval [CI]: 0.12-0.31) and infection (odds ratio = 0.30, 95% CI: 0.15-0.60) in PICC patients, increased the maximum venous velocity (mean difference = 3.02, 95% CI: 1.87-4.17) and mean blood flow (mean difference = 3.10, 95%CI: 1.57-4.62) in PICC patients (all P < .05). There were no publication biases amongst the synthesized outcomes (all P > .05). CONCLUSION Quantified grip exercises can effectively reduce the occurrence of PICC-related thrombosis and infection, improve the venous hemodynamics. Limited by study population and regions, large-sample, and high-quality RCTs are still needed in the future to further evaluate the effects and safety of quantified grip exercises in PICC patients.
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Affiliation(s)
- Hongliang Luo
- Department of cardiothoracic surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Cheng Jin
- Department of urology surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaohong Li
- Department of urology surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yinzhu Jiang
- Department of urology surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Zhou
- Department of neonatal surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
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Li S, Lu H. Functions of Heparin Sodium Injection in the Prevention of Peripherally Inserted Central Catheter-Related Venous Thrombosis in NSCLC Patients during Postoperative Chemotherapy. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1239058. [PMID: 36299679 PMCID: PMC9592220 DOI: 10.1155/2022/1239058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022]
Abstract
Objective This study intended to analyze hazardous factors of venous thrombosis by comparing the effect of different doses of heparin sodium injection on the incidence rate of peripherally inserted central catheter (PICC)-related venous thrombosis in non-small cell lung carcinoma (NSCLC) patients during postoperative chemotherapy. Methods 425 NSCLC patients who received PICC catheterization in Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital from July 2019 to July 2021 were collected. Based on their different pathological types, patients were given two different chemotherapy regimens: pemetrexed+cisplatin or paclitaxel+cisplatin. Patients were grouped according to the different doses of heparin sodium injection adopted. Control group (n = 140). Catheters were sealed with 10 mL saline only. Group I (n = 142). In addition to routine maintenance with normal saline, 2 mL of 10 IU/mL heparin sodium injection was sealed in the catheters under positive pressure every time after catheterization. Group II (n = 143). In addition to routine maintenance with normal saline, 5 mL of 10 IU/mL heparin sodium injection was sealed in the same manner as Group I. The baseline characteristics of the three groups of patients were compared by statistical means. Doppler ultrasonography was applied to check the venous thrombosis. The hazardous factors of venous thrombosis were analyzed through correlation analysis and binary logistic regression method. Results The incidence rates of thrombosis in the control group, Group I, and Group II were 20.00%, 7.04%, and 2.09%, respectively, with statistically significant differences (P < 0.01). Additionally, through the collinear correlation analysis of baseline characteristics, a significant correlation between the dosage of heparin sodium injection and the incidence of thrombosis was observed (P < 0.05), but there were no significant differences between other baseline data and the incidence of thrombosis (P > 0.05). Binary logistic regression analysis revealed that postoperative use of heparin sodium injection (Group I: OR = 0.312; P = 0.003; Group II: OR = 0.082, P < 0.001) was a protective factor for preventing thrombosis. In addition, the thromboprophylaxis effect of Group II was better than that of Group I. No serious adverse reactions were found in safety analysis. Conclusion Heparin sodium could significantly lower the incidence rate of PICC-related venous thrombosis in NSCLC patients during postoperative chemotherapy. Heparin sodium injection is safe enough to be promoted among PICC patients with a high risk of venous thrombosis.
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Affiliation(s)
- Shanquan Li
- Venous Catheterization Nursing Clinic, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital, Shenzhen, Guangdong Province, China 518100
| | - Hong Lu
- Nursing Department, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital, Shenzhen, Guangdong Province, China 518100
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Huang X, Xie M, Zhao S, Chen Y, Wu L, Zeng X. Benefits of an online multimodal nursing program among patients with peripherally inserted central catheter-related thrombosis. Front Public Health 2022; 10:971363. [PMID: 36203676 PMCID: PMC9531013 DOI: 10.3389/fpubh.2022.971363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/31/2022] [Indexed: 01/25/2023] Open
Abstract
Background Asymptomatic peripherally inserted central catheter-related thrombosis (PICC-RT) is one of the most common and dangerous complications caused by peripherally inserted central catheter (PICC) insertion. A variety of factors might lead to huge psychological pressures on patients and markedly affect their quality of life. The aim of this study was to evaluate the benefits of an online multimodal nursing program on the quality of life and psychological resilience of asymptomatic PICC-RT patients with ovarian cancer. Methods This was a prospective cohort study on patients with asymptomatic PICC-RT. Patients in the control group received routine nursing care, while patients in the intervention group obtained extra assistance through an online multimodal nursing program. Individual guidance, psychological support, and real-time consultation were provided to patients in the intervention group. All participants were followed for 3 months. The health-related quality of life and psychological resilience of patients were evaluated by using the 36-item Short Form Health Survey (SF-36) and Connor-Davidson Resilience Scale (CD-RISC), respectively. Results Compared to baseline, most of the items in the SF-36 scores were significantly increased in both intervention and control groups after 3 months (all p < 0.05), except for the role emotional domain (p = 0.085 in control group). However, the SF-36 scores of the intervention group were significantly higher than those of the control group in All health domains, including physical functioning (p = 0.001), role physical (p = 0.004), bodily pain (p = 0.003), general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001), role emotional (p = 0.002), mental health (p < 0.001) and health transition (p < 0.001). For CD-RISC scores, the mean value of the control group was 42.03 ± 4.42 at baseline and increased to 50.36 ± 4.70 after 3 months (p < 0.001), while the intervention group was 40.00 ± 6.61 at baseline and increased to 65.12 ± 5.21 after 3 months (p < 0.001). Moreover, the CD-RISC score in the intervention group was significantly higher than that in the control group after 3 months (p < 0.001). Conclusion The application of an online multimodal nursing program could significantly improve the health-related quality of life and psychological resilience of asymptomatic PICC-RT patients. These findings provide evidence to support the necessity of an online multimodal nursing program in routine long-term follow-up, especially in the era of COVID-19.
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Zhang Q, Peng H, Hu L, Ren R, Peng X, Song J. Association Between ABO Blood Group and Venous Thromboembolism Risk in Patients With Peripherally Inserted Central Catheters: A Meta-analysis and Systematic Review. Front Oncol 2022; 12:906427. [PMID: 35875074 PMCID: PMC9304918 DOI: 10.3389/fonc.2022.906427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 01/10/2023] Open
Abstract
Background Previous studies have evaluated the association between ABO blood group and venous thromboembolism (VTE) risk in patients with peripherally inserted central catheters (PICCs). However, it remains unclear whether ABO blood groups are associated with PICC-associated VTE risk. Therefore, we conducted a meta-analysis of related studies to elucidate the potential role of ABO blood group as a risk factor for PICC-associated VTE. Methods All detectable case–control and cohort studies comparing the role of ABO blood group as a risk factor for PICC-associated VTE were collected for this analysis by searching PubMed, Embase, CNKI, Web of Science, and Wanfang. We conducted a meta-analysis of the eligible studies and computed the summary risk estimates with random or fixed effects models. Results A total of four studies involving 7,804 patients were included. Meta-analysis of the studies showed that the risk of PICC-associated VTE was significantly higher in blood types A [odds ratio (OR)=1.54, 95% CI=1.17–2.03), p=0.002], B (OR=2.35, 95% CI=1.71–3.23, p<0.0001), and AB (OR=2.55, 95% CI=1.68–3.88, p<0.0001) and lower in blood types O (OR=0.58, 95% CI=0.45–0.74, p<0.0001). Subgroup analysis based on ethnicity demonstrated that blood type O may be a genetic protective factor for PICC-associated VTE in Asians. Among Caucasians, individuals with blood types B and AB have a higher risk of PICC-associated VTE. Blood types A, B, and AB are risk factors for PICC-associated VTE in Asians. Conclusions Blood type O is associated with a decreased risk of PICC-associated VTE, especially in Asian populations. Moreover, blood types A, B, and AB are risk factors for PICC-associated VTE.
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Affiliation(s)
| | | | | | | | | | - Jifang Song
- *Correspondence: Xingqiao Peng, ; Jifang Song,
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Wang P, Soh KL, Ying Y, Liu Y, Huang X, Huang J. Risk of VTE associated with PORTs and PICCs in cancer patients: A systematic review and meta-analysis. Thromb Res 2022; 213:34-42. [DOI: 10.1016/j.thromres.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 12/12/2022]
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