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The timing and sequence of multiple device‐related complications in patients with long term indwelling Groshong catheters
Author(s) -
Tolar Blair,
Gould James R.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960915)78:6<1308::aid-cncr20>3.0.co;2-3
Subject(s) - medicine , complication , catheter , surgery , thrombosis , venous thrombosis
BACKGROUND The function of long term indwelling venous access devices is commonly perturbed by postinsertion catheter‐related complications (CRC). In an effort to assess the patterns of CRC in our community accurately, a prospective analysis of Groshong catheters in adult cancer patients was undertaken. METHODS Three hundred and twenty‐four consecutive adult oncology patients in whom a Groshong catheter was utilized for long term central venous access were observed for the development of a CRC. A subset analysis was undertaken of those catheters that developed one or more complications. RESULTS Among the 221 catheters with a primary complication, 176 additional complications were subsequently identified (109 2nd, 50 3rd, and 17 4th complicating events). Ball‐valve effect (BVE), the most frequent complication, was found to occur disproportionately as a primary event (85 of 119 catheters, P < 0.01), whereas catheter‐related venous thrombosis (CR‐VT) was more likely to occur as a later, subsequent complication (46 of 66 catheters, P < 0.01). Although risk analysis affirmed a paucity of clinical predictors for developing a primary complication, patients with BVE as a first complication were at increased risk for developing a later episode of CR‐VT. CONCLUSIONS Multiple sequential complications are common in patients with Groshong catheters, occurring in a rather predictable sequence. The increased risk of CR‐VT in patients with catheters with an early complication suggests a cause‐effect relationship. An awareness of this sequencing may lead to improved strategies for the prevention of primary and subsequent complications. Cancer 1996;78:1308‐13.