Piran et al identified risk factors for symptomatic venous thromboemboli associated with an implanted port in a patient with cancer. A patient at risk for thrombosis might benefit from thromboprophylaxis. The authors are from the University of Ottawa and The Ottawa Hospital.
Patient selection: cancer, with port implanted to administer chemotherapy
Outcome: symptomatic thromboemboli (occurred in about 9% of patients)
Symptomatic thromboemboli include:
(1) upper extremity thrombosis
(2) thrombosis related to the intravascular catheter
(3) pulmonary embolism
(4) lower extremity thrombosis
None of the patients received thromboprophylaxis.
Risk factors for symptomatic thromboemboli on multivariate analysis:
(1) metastatic cancer (OR 8.2)
(2) male gender (OR 2.2)
A right-sided port was a risk factor in the univariate analysis.
The cumulative incidence of symptomatic thromboemboli increases the longer that the port has been in place.
Some factors that may not have been tested in the model:
(1) a previous history of thromboemboli
(2) the histologic type of cancer (mucinous adenocarcinoma, other)
