The use of low-dose warfarin as prophylaxis for central venous catheter thrombosis in patients with cancer: A meta-analysis

Purpose/Objectives: To determine whether the use of low-dose warfarin could reduce the incidence of thrombosis in patients with cancer who have a central venous catheter (CVC). Data Sources: MEDLINE (R), CINAHL (R), CANCERLIT (R), EMBASE (R), and the Cochrane Library. Data Synthesis: Meta-analysis of four studies (N = 1,236 patients) revealed that 6.4% of warfarin-treated patients experienced a thrombotic event compared with 7.5% in the control (no treatment) group. The risk difference for thrombus formation was not significant (2.0%, confidence interval = -9.0% to 5.0%). Conclusions: The administration of warfarin did not reduce the incidence of symptomatic or asymptomatic CVC-associated thrombosis in patients with cancer. Implications for Nursing: Using research findings to inform clinical nursing practice is important in caring for patients and providing optimal and improved patient outcomes. Prophylactic use of low-dose warfarin may not prevent thrombus formation and is associated with potentially adverse patient outcomes.