The Clinical Study On Risk Factors Of PICC-associated Thrombus In Postoperative Chemotherapy For Gastric Cancer And Colorectal Cancer

Background:In China,colorectal cancer and gastric cancer rank second and third among malignancies with respect to the incidence,respectively,and the current mainstay of treatment for most cases is the surgical incision complemented with postoperative chemotherapy.In recent years,preoperative neoadjuvant therapy and translational therapy have been gradually accepted by both patients and physicians.However,most chemotherapeutics and targeting drugs are highly irritant and very toxic,which prompts us to look for an infusion mode which is safer,more reliable,and has less impact on quality of life of patients.Peripherally inserted central venous catheters(PICC)are custom-made catheters inserted via puncture through an arm vein,with the tip reaching the junction of the superior vena cava(SVC)/vena cava and both atria.They can reduce damage to vessels and decrease the incidence of phlebitis during infusion of hypertonic fluids or chemotherapeutics,and meanwhile,they can be carried for a prolonged time period.Unfortunately,there is a high incidence of thrombosis due to PICC,and thrombus dislodgement may lead to life-threatening pulmonary embolism.Objective:The aim of the study is to explore the risk factors for PICC-related thrombosis in postoperative chemotherapy in patients with colorectal or gastric cancer.Methods:Patients who were diagnosed with malignant gastric or colorectal cancer and underwent postoperative chemotherapy with a PICC in the Gastrointestinal Surgery/Hernia Surgery of The First Hospital of China Medical University between April 2020 and December 2021 were selected.All participants had complete clinical data.According to the incidence of PICC-related thrombosis,two groups were generated: Thrombus group,and No-thrombus group.The general and clinical data of patients were compared between groups.Univariate and multivariate analyses were used to explore the risk factors for PICC-related thrombosis.Results : In this study,the incidence of PICC-related thrombosis was 25.3%.In univariate analysis,smoking history(P =0.022)and hypertension(P =0.045)had statistical significance.While in the multivariate analysis,hypertension was statistically significant,and smoking history was marginal statistically significant.Conclusion:Smoking history is the risk factor for PICC-related thrombosis during chemotherapy after surgery for malignancy gastric/colorectal cancer,and administration of antihypertensive drugs in cases with hypertension may suppress the formation of PICC-related thrombus.