The Michigan Risk Score to predict peripherally inserted central catheter-associated thrombosis.

Area of Science:

• Medical Devices
• Vascular Access
• Thrombosis Research

Background:

• Peripherally inserted central catheters (PICCs) are linked to upper extremity deep vein thrombosis (DVT).
• Quantifying thrombosis risk associated with PICCs is crucial for patient safety.
• Existing methods for risk assessment are insufficient.

Purpose of the Study:

• To develop and validate a risk score for predicting PICC-related DVT.
• To identify key risk factors associated with PICC-DVT.
• To stratify patients into distinct risk classes for thrombosis.

Main Methods:

• Utilized data from the Michigan Hospital Medicine Safety Consortium.
• Employed a logistic, mixed-effects model to identify DVT predictors.
• Developed the Michigan Risk Score (MRS) by assigning points to risk factors.
• Validated the score internally using bootstrapping.

Main Results:

• Identified five risk factors for PICC-DVT: history of DVT, multi-lumen PICC, active cancer, concurrent CVC use, and elevated white blood cell count.
• Developed four risk classes (I-IV) with increasing DVT rates (0.9% to 4.7%).
• The MRS demonstrated strong predictive capability for PICC-DVT.

Conclusions:

• The Michigan PICC-DVT Risk Score (MRS) provides a validated tool for estimating thrombosis risk.
• The MRS can assist clinicians in determining the appropriateness of PICC insertion.
• This score enhances the management of patients requiring PICCs.