Anticoagulation prophylaxis for central venous catheter-associated thrombosis in cancer patients: An Australian perspective

Abstract

Background: The use of indwelling central venous catheters (CVC) for chemotherapy delivery is essential for people receiving therapies by protracted venous infusion and for patients with difficult venous access. Complications include infection and catheter-related thrombosis. Strategies have been suggested to prevent catheter-related thrombosis, however, there is no clear consensus on how to proceed. Guidelines recommend against the use of prophylactic anticoagulation in adult patients with solid organ malignancies and an indwelling CVC. We investigated the practice of Australian medical oncologists. Methods: Awritten questionnaire was mailed to all members of the Medical Oncology Group of Australia assessing practices of prophylactic anticoagulation in adult patients with solid organ malignancies and CVC. Results: Responses were obtained from 141 (55%) medical oncologists andfrom 40 advanced trainees. Ten percent (n = 4) of oncology trainees and 18.4% (n = 26) of medical oncologists routinely administered anticoagulants to patients with a CVC without a previous history of line-related thrombus. The most common strategy employed (73% of those using anticoagulation) was to recommend 1mg of warfarin. Conclusions: The results demonstrate that a significant number of patients in Australia receive routine anticoagulation, the most popular strategy being the use of low-dose warfarin. Based on our results there is a clear need for further education regarding the lack of supporting data and the potential harm that may ensue. © 2008 The Authors Journal Compilation © Blackwell Publishing Asia Pty Ltd.