A prospective study on the incidence and risk factors of central venous catheter-related thrombosis after gastrointestinal surgery

Abstract

Objective To investigate the incidence and risk factors of central venous catheter-related thrombosis after gastrointestinal surgery. Methods From May 2018 to May 2019, 124 patients who received surgical treatment with central venous catheter placement in gastrointestinal surgery department at Harrsion International Peace Hospital were prospectively analyzed, and the factors that may be related to catheter-related thrombosis were collected.And performed ultrasound screening before the removal of central venous catheter, According to whether there was thrombosis or not, they were divided into thrombosis group(n=66) and non-thrombosis group(n=58). Multivariate logistic regression analysis was performed for the factors with statistical differences between the two groups. Results A total of 66 patients were diagnosed with catheter-related thrombus by ultrasonography, with an incidence of 53.2%(66/124), 63 cases with no clinical symptoms(50.8%), only 3 cases with clinical symptoms, and the incidence of catheter-related thrombus with symptoms was 2.4%(3/124). The operation type, central venous catheter indwelling time, fibrinogen on the 3rd day after surgery and D-dimer on the 3rd day after surgery between the two groups had statistically significant differences (χ2=21.415, 7.651, t=5.7181, 0.418, all P<0.05). Multivariable logistic regression analysis showed that operation type(OR=0.157, 95%CI: 0.040-0.612, P=0.008), fibrinogen on the 3rd day after surgery(OR=7.371, 95%CI: 2.318-23.442, P=0.001), D-dimer on the 3rd day after surgery(OR=6.920, 95%CI: 2.854-16.783, P=0.000) were independent risk factors of catheter-related thrombosis. Conclusion The incidence of central venous catheter-related thrombosis is higher after gastrointestinal surgery, and most patients have no obvious clinical symptoms.The patients who undergoing tumor surgery or with abnormal levels of fibrinogen and D-dimer on the 3rd day after surgery should aware of catheter-related thrombosis. Key words: Gastrointestinal diseases; Surgery; Central venous catheters; Venous thrombosis; Risk factor; Neoplasms; Fibrinogen; Fibrin fragment D