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Prediction tool for thrombi associated with peripherally inserted central catheters.

Maria A Seeley1, Mary Santiago, Susan Shott

  • 1Adventist Hinsdale Hospital, Department of PICC Services, Hinsdale, IL 60521, USA. maria.seeley@ahss.org

Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society
|September 27, 2007
PubMed
Summary

Upper extremity deep vein thrombosis (UEDVT) is rising with central catheter use. A new prediction tool helps identify high-risk patients for prophylaxis, showing high sensitivity and specificity.

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Published on: November 26, 2013

Area of Science:

  • Medical research
  • Vascular medicine
  • Patient safety

Background:

  • Increasing incidence of upper extremity deep vein thrombosis (UEDVT) associated with peripherally inserted central catheters (PICCs).
  • Limited understanding of risk factors for UEDVT compared to lower extremity deep vein thrombosis.
  • Need for effective prophylaxis strategies in at-risk patient populations.

Purpose of the Study:

  • To identify patients at highest risk for developing upper extremity deep vein thrombosis.
  • To develop a predictive tool for upper extremity deep vein thrombosis to guide prophylactic measures.
  • To improve patient outcomes by mitigating risks associated with central venous catheterization.

Main Methods:

  • Retrospective review of medical records for patients with peripherally inserted central catheters over a 6-month period.
  • Analysis of patient data to identify potential risk factors for upper extremity deep vein thrombosis.
  • Development and validation of a weighted risk factor measure, the upper extremity deep vein thrombosis prediction tool.

Main Results:

  • A total of 233 patient records were reviewed, with 17 (7.3%) cases of upper extremity deep vein thrombosis identified.
  • The developed upper extremity deep vein thrombosis prediction tool demonstrated high sensitivity (88%) and specificity (82%).
  • The tool achieved a high negative predictive value (99%) and correctly classified 82% of cases, though positive predictive value was lower (28%).

Conclusions:

  • The developed upper extremity deep vein thrombosis prediction tool shows promise in identifying patients at high risk.
  • Further validation on a larger patient sample is recommended to confirm the instrument's efficacy.
  • The tool can potentially aid in initiating timely and effective prophylaxis for upper extremity deep vein thrombosis.