Analysis Of The Incidence And Risk Factors Of Catheter-related Thrombus In Breast Cancer Patients With TIVAP In A 3A Hospital In Changchun

Breast cancer is one of the most common malignancies for women worldwide,causing severe damage to the health of women.With the development of global medical technology,the diagnosis and treatment of breast cancer has gradually become more diverse,and comprehensive treatment has become the first choice.As an indispensable treatment method,chemotherapy in the comprehensive treatment of breast cancer can improve the surgical resection rate,reduce staging,and reduce tumor volume,which has important clinical effects.The method of chemotherapy administration has gradually evolved from traditional peripheral intravenous administration to completely implantable venous infusion port(TIVAP).The TIVAP has been widely used and popularized among patients in need of long-term infusion due to its unique advantages of reducing the number of puncture,protecting peripheral tissues and long-term indwelling.However,with the increasing application of TIVAP,complications such as catheter-related thrombosis(CRT)have gradually been valued by people.It is very important to analyze and discuss the risk factors that affect the formation of CRT.Objective:1.We aim to investigate the occurrence of CRT in breast cancer patients after TIVAP implantation and explore the risk factors of CRT after TIVAP implantation.2.Establish a predictive model of CRT after TIVAP implantation,and evaluate the accuracy of the predictive model,providing a reliable clinical basis for the prevention of CRT during TIVAP implantation.Methods:A total of 280 breast cancer patients who met the inclusion criteria and needed TIVAP implantation were included in a 3A hospital in Changchun from January 2017to October 2018.This research object of study of general information collected through the electronic medical record,such as age,marital status"place smoking situation,as well as the research object of clinically relevant data such as tumor staging tumor molecular classification whether hypertension diabetes mellitus BMI D-dimer level set port time puncture times,etc according to the number of people at the end of the tube after a total of CRT,calculate the incidence of CRT.Count data were expressed as composition ratio(%),andc~2 test was used for comparison between groups.Multivariate logistic regression was used to analyze the risk factors of thrombosis after TIVAP implantation in breast cancer patients.Based on the results,a risk assessment model of CRT was established,and the ROC curve of this model was drawn.All statistical tests were two-sided tests,and P<0.05 was considered statistically significant.Results:1.In this study,a total of 280 patients with breast cancer implanted into TIVAP were included,among whom 117 had CRT,with an incidence of 41.79%.2.The results of univariate analysis showed that the incidence of thrombosis after TIVAP implantation was different in breast cancer patients of different ages(P<0.05).The older the patient,the more thrombus occurred after TIVAP implantation;The incidence of thrombosis was greater in patients with BMI?25(P<0.05);Compared with patients without diabetes,patients with diabetes mellitus are more prone to thrombosis after admission(P<0.05);Compared with patients with normal plasma D-dimer levels,the incidence of thrombosis was higher in patients who have abnormal D-dimer levels(P<0.05).No differences were found in the incidence of thrombosis in patients with different places of residence,history of hypertension,smoking,tumor staging,tumor molecular classification,and number of punctures(P>0.05).3.Multivariate analysis results showed that age,BMI index,comorbid diabetes,plasma D-dimer level,and time to port were the influencing factors of CRT in breast cancer patients after TIVAP implantation.For every one year of age,the risk of CRT is increased by 2.881 times(OR=2.881,95%CI:1.342-9.675);Breast cancer patients with BMI?25 have a 2.833-fold higher risk of CRT after intubation than patients with BMI<25(OR=2.833,95%CI:1.255-10.166);The risk of CRT after intubation in patients with breast cancer with diabetes was 1.632 times that of patients without diabetes(OR=1.632,95%CI:1.092-3.437);Breast cancer patients with abnormal plasma D-dimer levels have a 28.624 times greater risk of CRT after intubation than patients with normal plasma D-dimer levels(OR=28.624,95%CI:4.742-172.686).4.Based on the results of Logistic regression analysis,a risk prediction model for CRT after TIVAP implantation in breast cancer patients is established:Y=-1.507+1.058×age+1.041×BMI+0.490×combined diabetes+3.354×abnormal plasma D-dimer level.The ROC curve is used to evaluate the effectiveness of the prediction model.The results showed that the area under the curve(AUC)was 0.935,the sensitivity was 0.964,and the specificity was 0.905.Conclusions:1.In this study,117 breast cancer patients developed CRT after TIVAP implantation,with an incidence of 41.79%.2.Patients with advanced age,high BMI,diabetes mellitus,abnormal plasma d-dimer level of breast cancer have a greater risk of catheter-related thrombosis.3.The risk prediction model:Y=-1.507+1.058×age+1.041×BMI+0.490×combined diabetes+3.354×abnormal plasma D-dimer level,can better predict the risk of CRT after breast cancer patients with TIVAP implantation.