Incidence and characteristics of catheter-related thrombosis in children with malignant tumors: a single-center retrospective cohort study.
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BACKGROUND: Venous thromboembolism (VTE) is a frequent complication during the treatment of pediatric malignancies. The use of central venous access devices (CVADs) represents a significant risk factor for VTE. While prior studies have investigated VTE and catheter-related thrombosis (CRT) in general pediatric populations, comprehensive data on the incidence and risk factors specific to Chinese pediatric oncology patients remain scarce. AIM: To retrospectively evaluate the incidence and characteristics of CRT in a single-center cohort of pediatric oncology patients in China, thereby addressing this existing evidence gap. DESIGN: Single-center retrospective cohort study. METHODS: Medical records from 785 pediatric oncology patients who underwent CVAD placement at our institution were retrospectively reviewed. Collected variables included age, sex, cancer type, catheter type, CRT occurrence, laboratory indices, and clinical outcomes. Statistical analysis were performed using chi-square tests for categorical variables and independent or paired t-tests for continuous variables. RESULTS: Among the 785 patients, 20 ( 2.5%) developed CRT. The majority (94.1%) received peripherally inserted central catheters (PICCs), which were associated with a lower CRT incidence (1.9%) compared with central venous catheters (CVCs) (16.7%) and totally implantable venous access ports (TIVAPs) (10.7%) (P < 0.001). A significant post-diagnosis increase in D-dimer levels was observed in patients with CRT (P = 0.040). The incidence of CRT did not differ significantly between patients with hematologic malignancies (2.6%) and those with solid tumors (2.4%). Most CRT cases (70.0%) occurred within the first month after catheter insertion. Symptomatic CRT predominated in the PICC group (78.6%), while asymptomatic CRT was more frequent in the CVC and TIVAP groups (83.3%). No CRT-related complications were observed during the 6-month follow-up period after CRT diagnosis. CONCLUSION: PICCs were associated with a lower incidence of CRT compared with other catheter types. Although elevated D-dimer levels were observed following CRT diagnosis, further research is warranted to clarify its potential screening value. CLINICAL TRIAL NUMBER: Not applicable.