PD314 - INCIDENCE OF CATHETER-RELATED VENOUS THROMBOSIS IN ADULT PATIENTS WITH CHRONIC INTESTINAL FAILURE ON LONG-TERM HOME PARENTERAL SUPPORT

PD314

INCIDENCE OF CATHETER-RELATED VENOUS THROMBOSIS IN ADULT PATIENTS WITH CHRONIC INTESTINAL FAILURE ON LONG-TERM HOME PARENTERAL SUPPORT

U. Aimasso¹, B. Mussa², A. Evangelista³, F. D. Merlo¹, M. Ossola¹, E. Olimpio², S. Bo^2,*

¹Clincal Nutrition Unit, ²University of Torino, ³Epidemiology Unit, Torino, Italy

Rationale: Catheter-related venous thrombosis (CRVT) represents a major complication in patients with chronic intestinal failure (CIF) requiring long-term parenteral support (PS). We aimed to assess the incidence, clinical presentation, and risk factors for CRVT in this population.

Methods: Among 424 patients with CIF, 370 met eligibility criteria and were included. Median follow-up was 35.7 months (IQR 16.1-75.3). Overall, 1,196 catheter placements were recorded (median 3 per patient). CRVT incidence was calculated per catheter-days, and predictors of first CRVT were evaluated using multivariable Cox regression.

Results: Mean age was 58 years, and 47% were male. The most common underlying condition was type I short bowel syndrome, mainly due to Crohn disease or cancer surgery. A total of 117 CRVTs occurred over 615,175 catheter-days (0.190/1,000 catheter-days). At 12 months, cumulative incidence was 8.7% (95% CI 7.0-10.8), with asymptomatic events (4.8%) slightly more frequent than symptomatic events (3.9%). Overall, 87 patients (23.5%) experienced ≥1 CRVT; 59.8% of events were asymptomatic. Most CRVTs occurred in the first implanted catheter (44.8%). In multivariable analysis, increasing age and use of a first tunneled/totally implantable catheter were independently associated with lower CRVT risk. Conversely, prophylactic and therapeutic anticoagulation, peripherally inserted central catheters -PICCs- placed in the basilic vein, Crohn disease, and prior cancer were associated with increased risk.

Conclusion: CRVT is common in patients with CIF, frequently asymptomatic, and influenced by both patient- and catheter-related factors. Given the need to preserve long-term venous access for life-sustaining therapy, careful selection of the initial catheter appears crucial.

Disclosure of Interest: None declared