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Takahashi T, Morita K, Uda K, Matsui H, Yasunaga H, Nakagami G. Complications after peripherally inserted central catheter versus central venous catheter implantation in intensive care unit: propensity score analysis using a nationwide database. Expert Rev Med Devices 2024; 21:447-453. [PMID: 38661659 DOI: 10.1080/17434440.2024.2346191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND It remains unclear whether peripherally inserted central catheters (PICCs) are superior to central venous catheters (CVCs); therefore, we compared post-implantation complications between CVC and PICC groups. RESEARCH DESIGN AND METHODS Patients who received CVCs or PICCs between April 2010 and March 2018 were identified from the Diagnosis Procedure Combination database, a national inpatient database in Japan. The outcomes of interest included catheter infection, pulmonary embolism, deep vein thrombosis, and phlebitis. Propensity score overlap weighting was used to balance patient backgrounds. Outcomes were compared using logistic regression analyses. RESULTS We identified 164,185 eligible patients, including 161,605 (98.4%) and 2,580 (1.6%) in the CVC and PICC groups, respectively. The PICC group was more likely to have overall complications (odds ratio [OR], 1.70; 95% confidence interval [CI], 1.32-2.19), pulmonary embolism (OR, 2.32; 95% CI, 1.38-3.89), deep vein thrombosis (OR, 1.86; 95% CI, 1.16-2.99), and phlebitis (OR, 1.72; 95% CI, 1.27-2.32) than the CVC group. There was no significant intergroup difference in catheter infection (OR, 1.09; 95% CI, 0.39-3.04). CONCLUSIONS Patients with PICCs had a significantly greater incidence of complications than did those with CVCs. Further research is necessary to explore the factors contributing to these complications.
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Affiliation(s)
- Toshiaki Takahashi
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kojiro Morita
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuaki Uda
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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2
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Curtis K, Gough K, Krishnasamy M, Tarasenko E, Hill G, Keogh S. Central venous access device terminologies, complications, and reason for removal in oncology: a scoping review. BMC Cancer 2024; 24:498. [PMID: 38641574 PMCID: PMC11027380 DOI: 10.1186/s12885-024-12099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/08/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Lack of agreed terminology and definitions in healthcare compromises communication, patient safety, optimal management of adverse events, and research progress. The purpose of this scoping review was to understand the terminologies used to describe central venous access devices (CVADs), associated complications and reasons for premature removal in people undergoing cancer treatment. It also sought to identify the definitional sources for complications and premature removal reasons. The objective was to map language and descriptions used and to explore opportunities for standardisation. METHODS A systematic search of MedLine, PubMed, Cochrane, CINAHL Complete and Embase databases was performed. Eligibility criteria included, but were not limited to, adult patients with cancer, and studies published between 2017 and 2022. Articles were screened and data extracted in Covidence. Data charting included study characteristics and detailed information on CVADs including terminologies and definitional sources for complications and premature removal reasons. Descriptive statistics, tables and bar graphs were used to summarise charted data. RESULTS From a total of 2363 potentially eligible studies, 292 were included in the review. Most were observational studies (n = 174/60%). A total of 213 unique descriptors were used to refer to CVADs, with all reasons for premature CVAD removal defined in 84 (44%) of the 193 studies only, and complications defined in 56 (57%) of the 292 studies. Where available, definitions were author-derived and/or from national resources and/or other published studies. CONCLUSION Substantial variation in CVAD terminology and a lack of standard definitions for associated complications and premature removal reasons was identified. This scoping review demonstrates the need to standardise CVAD nomenclature to enhance communication between healthcare professionals as patients undergoing cancer treatment transition between acute and long-term care, to enhance patient safety and rigor of research protocols, and improve the capacity for data sharing.
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Affiliation(s)
- Kerrie Curtis
- Department of Nursing, University of Melbourne, Melbourne, Australia.
- Peter MacCallum Cancer Centre, Melbourne, Australia.
- Austin Health, Melbourne, Australia.
| | - Karla Gough
- Department of Nursing, University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Meinir Krishnasamy
- Department of Nursing, University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre Alliance, Melbourne, Australia
| | | | - Geoff Hill
- Royal Melbourne Hospital, Melbourne, Australia
| | - Samantha Keogh
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
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Zaccone V, Santoro L, Guerrieri E, Diblasi I, Roncarati I, Viticchi G, Vecchiarelli P, Santoliquido A, Fiore F, Molfino A, Landi F, Moroncini G, Gasbarrini A, Muscaritoli M, Falsetti L. Prevention and treatment of catheter-related venous thrombosis in long-term parenteral nutrition: A SINuC position statement. Front Nutr 2023; 10:1106327. [PMID: 36814508 PMCID: PMC9940014 DOI: 10.3389/fnut.2023.1106327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/13/2023] [Indexed: 02/08/2023] Open
Abstract
The implementation of long-term parenteral nutrition (PN) often requires the placement of central venous access, a procedure that carries a considerable risk of catheter-related venous thrombosis (CRT). The occurrence of CRT represents a major event in the natural history of patients in PN since it can lead to central venous access loss and PN failure. Despite the importance of this topic in clinical nutrition, the prevention and treatment of CRT in PN represents one of the "gray areas" of the literature of the presence of few randomized controlled clinical trials and the generally low level of evidence of published scientific papers. Through a narrative review of the literature and a Delphi consensus, the Italian Society of Clinical Nutrition and Metabolism (SINuC) aimed to collect some practical recommendations regarding the current state-of-the-art in the prevention, diagnosis, and treatment of CRT in patients undergoing long-term PN.
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Affiliation(s)
- Vincenzo Zaccone
- Internal and Emergency Medicine, Marche University Hospital, Ancona, Italy
| | - Luca Santoro
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,*Correspondence: Luca Santoro, ; orcid.org/0000-0003-3614-7314
| | - Emanuele Guerrieri
- Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy
| | - Ilaria Diblasi
- Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy
| | - Ilaria Roncarati
- Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy
| | | | | | - Angelo Santoliquido
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Fiore
- Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessio Molfino
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Landi
- Università Cattolica del Sacro Cuore, Rome, Italy,Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Antonio Gasbarrini
- Università Cattolica del Sacro Cuore, Rome, Italy,Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Falsetti
- Internal and Emergency Medicine, Marche University Hospital, Ancona, Italy
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Zhang Q, Peng H, Hu L, Ren R, Peng X, Song J. Association Between ABO Blood Group and Venous Thromboembolism Risk in Patients With Peripherally Inserted Central Catheters: A Meta-analysis and Systematic Review. Front Oncol 2022; 12:906427. [PMID: 35875074 PMCID: PMC9304918 DOI: 10.3389/fonc.2022.906427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 01/10/2023] Open
Abstract
Background Previous studies have evaluated the association between ABO blood group and venous thromboembolism (VTE) risk in patients with peripherally inserted central catheters (PICCs). However, it remains unclear whether ABO blood groups are associated with PICC-associated VTE risk. Therefore, we conducted a meta-analysis of related studies to elucidate the potential role of ABO blood group as a risk factor for PICC-associated VTE. Methods All detectable case–control and cohort studies comparing the role of ABO blood group as a risk factor for PICC-associated VTE were collected for this analysis by searching PubMed, Embase, CNKI, Web of Science, and Wanfang. We conducted a meta-analysis of the eligible studies and computed the summary risk estimates with random or fixed effects models. Results A total of four studies involving 7,804 patients were included. Meta-analysis of the studies showed that the risk of PICC-associated VTE was significantly higher in blood types A [odds ratio (OR)=1.54, 95% CI=1.17–2.03), p=0.002], B (OR=2.35, 95% CI=1.71–3.23, p<0.0001), and AB (OR=2.55, 95% CI=1.68–3.88, p<0.0001) and lower in blood types O (OR=0.58, 95% CI=0.45–0.74, p<0.0001). Subgroup analysis based on ethnicity demonstrated that blood type O may be a genetic protective factor for PICC-associated VTE in Asians. Among Caucasians, individuals with blood types B and AB have a higher risk of PICC-associated VTE. Blood types A, B, and AB are risk factors for PICC-associated VTE in Asians. Conclusions Blood type O is associated with a decreased risk of PICC-associated VTE, especially in Asian populations. Moreover, blood types A, B, and AB are risk factors for PICC-associated VTE.
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Affiliation(s)
| | | | | | | | | | - Jifang Song
- *Correspondence: Xingqiao Peng, ; Jifang Song,
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5
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Peng SY, Wei T, Li XY, Yuan Z, Lin Q. A model to assess the risk of peripherally inserted central venous catheter-related thrombosis in patients with breast cancer: a retrospective cohort study. Support Care Cancer 2021; 30:1127-1137. [PMID: 34432170 DOI: 10.1007/s00520-021-06511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Limited risk assessment tool to stratify the risk of PICC-related thrombosis (PICC-RVT) in breast cancer patients. This study developed a model to assess the risk of PICC-RVT in breast cancer patients. METHODS We conducted a retrospective cohort study of 1284 breast cancer patients receiving PICC insertion from January 1, 2015, to August 31, 2019, at a cancer specialized hospital in Hunan province, China. The entire population was divided into two groups at a ratio of 3:1 which included a derivation sample (n = 978), and a validation sample (n = 284). PICC-RVT was confirmed by ultrasonography in the presence of clinical symptoms and signs. RESULTS PICC-RVT occurred in 40 (4.09%) of the derivation sample patients. Multivariable analysis identified 9 variables: chronic obstructive pulmonary disease, prior central venous catheter placement, higher level of platelets, higher level of D-dimer, lower level of activated partial thromboplastin time, menopause, no prior breast surgery, upper extremity lymphedema, and endocrine therapy. Points were assigned to each variable according to regression coefficient. The model had an area under the receiver operating characteristics curve (AUC) of 0.850 (95% CI 0.776 to 0.924), The Hosmer-Lemeshow goodness-of-fit was 5.780 (p = 0.328). At a cutoff value of 3.5, the sensitivity and specificity were 75% and 83%, respectively. CONCLUSION Several disease-specific factors of breast cancer (e.g., menopause, endocrine therapy, and upper extremity lymphedema) play important roles in the development of PICC-RVT. Patients at higher PICC-RVT risk could be candidates for close post-insertion monitoring and interventions to prevent PICC-RVT.
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Affiliation(s)
- Si-Yi Peng
- The Early Clinical Trial Center in The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan Province, China
| | - Tao Wei
- Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, 283 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan Province, China
| | - Xu-Ying Li
- Anesthesiology Department, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, 283 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan Province, China.
| | - Zhong Yuan
- Vascular Access Clinic, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan Province, China
| | - Qin Lin
- Vascular Access Clinic, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan Province, China
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Feng Y, Fu Y, Xiang Q, Xie L, Yu C, Li J. Plasminogen activator inhibitor-1 gene promoter 4G/5G polymorphism and risks of peripherally inserted central catheter-related venous thrombosis in patients with lung cancer: a prospective cohort study. Support Care Cancer 2021; 29:6431-6439. [PMID: 33893843 DOI: 10.1007/s00520-021-06207-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 04/07/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE This study investigated the influence of plasminogen activator inhibitor-1 (PAI-1) gene polymorphisms and other contributing clinical factors on peripherally inserted central catheter-related venous thrombosis (PICC-RVT) in Chinese patients with lung cancer. METHODS We conducted a prospective study of 237 participants. Blood samples were collected to detect the PAI-1 4G/5G genotype. Venous thromboembolism risk was calculated by the Caprini risk assessment model. Color Doppler ultrasonography was performed every 7 days for 3 weeks to confirm PICC-RVT. RESULTS The rate of PICC-RVT was 13.50% (32/237). The 5G/5G, 4G/5G, and 4G/4G genotypes were found in 12.50% vs 17.56%, 59.38% vs 49.27%, and 28.12% vs 34.17% in the thrombus group and the non-thrombus group of the participants. No difference was observed in the distribution frequency of the three genotypes between the thrombus and non-thrombus groups. A higher fibrinogen level (OR 1.194, 95% CI 1.004-1.420, P = 0.045) and a higher Caprini score (OR 1.698, 95% CI 1.103-2.614, P = 0.016) were statistically significant risk factors for PICC-RVT. Compared with patients who underwent a pemetrexed/cisplatin regimen, those who were administered paclitaxel/cisplatin (OR 18.332, 95% CI 2.890-116.278, P = 0.002) or gemcitabine/cisplatin (OR 6.617, 95% CI 1.210-36.180, P = 0.029) were at increased risk of PICC-RVT. CONCLUSION Our finding suggested that there is no statistically significant influence of the PAI-1 4G/5G gene variant on PICC-RVT in Chinese patients with lung cancer. However, patients with higher Caprini scores and higher fibrinogen levels are at increased risk for PICC-RVT, as are patients receiving chemotherapy. Clinical staff should carefully perform a risk assessment for patients with PICC. Those with the above risk factors should pay close attention and take timely and effective preventive measures.
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Affiliation(s)
- Yue Feng
- West China School of Nursing/Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yan Fu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Qiufen Xiang
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Lingling Xie
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Chunhua Yu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China.
| | - Junying Li
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China.
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Feng Y, Zheng R, Fu Y, Xiang Q, Yue Z, Li J, Yu C, Jiang Y. Assessing the thrombosis risk of peripherally inserted central catheters in cancer patients using Caprini risk assessment model: a prospective cohort study. Support Care Cancer 2021; 29:5047-5055. [PMID: 33594508 DOI: 10.1007/s00520-021-06073-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/09/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE There was no optimal risk assessment tool to stratify the risk of peripherally inserted central catheter-related venous thromboembolism (PICC-RVT) in cancer patients. We currently use the Caprini risk assessment model for thrombotic risk assessment, but no evidence exists on the effectiveness of Caprini in such patients. This study was to assess the validity of the Caprini in Chinese cancer patients with PICCs. METHODS We conducted a prospective study of 468 participants. Following calculating the Caprini score, color Doppler ultrasonography was performed every 7 days for 3 weeks to confirm PICC-RVT. RESULTS There was a correlation between PICC-RVT and the Caprini score. Compared with scores of 5, the risk was 2.089-fold greater (95% CI 1.165-3.743, P = 0.012) in patients with a score of 6 and 7, and 7.156-fold greater (95% CI 3.157-16.217, P < 0.001) in patients with scores ≥8. The area under the receiver-operating characteristic curve was 0.636 (95% CI 0.590-0.680; P < 0.001). 6 was the best cutoff point for Caprini, with a sensitivity of 0.76 and a specificity of 0.44. CONCLUSIONS The Caprini can be used for high-risk screening of the PICC-RVT in cancer patients, and classification of the highest risk level using a score of 6 can be more clinically significant compared to 5 as recommended. The results provide evidence for the practitioner's early use of the Caprini to assess the thrombotic risk in patients with PICCs and take timely prevention measures. But pharmacological prevention should be considered seriously for its low specificity.
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Affiliation(s)
- Yue Feng
- West China School of Nursing/Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Rujun Zheng
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Fu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiufen Xiang
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiying Yue
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Junying Li
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
| | - Chunhua Yu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China.
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Wang GD, Wang HZ, Shen YF, Dong J, Wang XP, Wang XZ, Zheng YY, Chen J, Guo SS. The Influence of Venous Characteristics on Peripherally Inserted Central Catheter-Related Symptomatic Venous Thrombosis in Cancer Patients. Cancer Manag Res 2020; 12:11909-11920. [PMID: 33244268 PMCID: PMC7685368 DOI: 10.2147/cmar.s282370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022] Open
Abstract
Background With increasing use, peripherally inserted central catheters (PICCs) are associated with the risk of venous thrombosis. Few studies have focused on the relationships between venous thrombosis and venous characteristics. This study aimed to identify effects of venous characteristics on symptomatic PICC-related venous thrombosis in cancer patients and explore the relationship between venous characteristics and blood flow velocity. Methods The data of patients who underwent placement of PICC were retrospectively studied between January 2015 and September 2017. Symptomatic PICC-related venous thrombosis was confirmed by ultrasound. Univariable, multivariable logistic regression analyses were performed to identify the risk factors associated with PICC-related venous thrombosis. In October 2017, 169 patients with PICCs were enrolled prospectively, and the relationships between blood flow velocity and venous characteristics were recorded and analyzed. Results A total of 2933 cancer patients were enrolled in this study; of these patients, 68 experienced symptomatic venous thrombosis. In the bivariate analysis, body mass index (BMI), history of venous thrombosis, triglycerides, tumor category, vessel diameter, vessel depth and arm circumference were associated with thrombosis. The multivariable analyses showed that arm circumference, vascular diameter, triglyceride level and tumor category were independent risk factors for thrombosis. Blood flow velocity was positively correlated with vessel depth and arm circumference but not with vessel diameter. Conclusion Different venous characteristics can lead to different blood flow rates, which can affect the incidence of thrombosis. A vein depth of greater than 1.07cm or less than 0.57cm was associated with a higher incidence of PICC-related venous thrombosis, and the greater the arm circumference and vessel diameter, the greater the risk of venous thrombosis.
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Affiliation(s)
- Guo-Dong Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Hong-Zhi Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Yan-Fen Shen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Jing Dong
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Xin-Peng Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Xiao-Zheng Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Yuan-Yuan Zheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Jie Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
| | - Shuang-Shuang Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China
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Bahl A, Karabon P, Chu D. Comparison of Venous Thrombosis Complications in Midlines Versus Peripherally Inserted Central Catheters: Are Midlines the Safer Option? Clin Appl Thromb Hemost 2019; 25:1076029619839150. [PMID: 30909723 PMCID: PMC6714901 DOI: 10.1177/1076029619839150] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Catheter-related (CR) thrombosis is a significant complication of midline catheters (MCs)
and peripherally inserted central catheters (PICCs). Limited existing data for MCs suggest
a favorable complication profile for MCs. To compare incidence of CR thrombosis between
MCs and PICCs and to evaluate the impact of quantity of lumens and catheter diameter on CR
thrombosis. This was a retrospective comparison spanning 13 months of MCs and PICCs for
symptomatic CR thrombosis at an 1100 bed tertiary care academic medical center. Adult
patients who had an MC or a PICC placed by the were included. Data were collected using
the electronic medical record. Statistical analysis was performed using SAS software. A
total of 2577 catheters were included in the analysis with 1094 MCs and 1483 PICCs. One
hundred thirty (11.88%) MCs developed CR thrombosis (deep vein thrombosis [DVT] or
superficial venous thrombophlebitis [SVT]) as compared to 112 (6.88%) PICCs (odds ratio
[OR]: 1.82; P < .0001). Midline catheters had a 53% greater odds of
developing CR DVT than PICCs (7.04% MCs and 4.72% PICCs; OR: 1.53; P =
.0126). For CR SVT, MCs have a 2.29-fold greater odds of developing CR SVT than PICCs
(4.84% MCs and 2.16% PICCs; OR: 2.29; P = .0002). For MCs and PICCs, the
incidence of CR thrombosis was 13.50% for double lumen/5F lines and was 6.92% for single
lumen/4F lines (OR: 2.10; P = <.0001). Symptomatic CR thrombosis is a
serious, life-threatening complication that occurs more frequently in MCs compared to
PICCs. Inserters should consider placement of single lumen catheters with the smallest
diameter to reduce this risk when a midline is used.
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Affiliation(s)
- Amit Bahl
- 1 William Beaumont Hospital, Royal Oak, MI, USA
| | - Patrick Karabon
- 2 Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - David Chu
- 2 Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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