Patterns and Predictors of Short-Term Peripherally Inserted Central Catheter Use: A Multicenter Prospective Cohort...

Area of Science:

• Medical Devices
• Hospital Medicine
• Infection Control

Background:

• Guidelines suggest avoiding peripherally inserted central catheters (PICCs) for anticipated use of 5 days or less.
• Short-term PICC utilization remains prevalent in hospital settings.
• Understanding factors and outcomes of short-term PICCs is crucial for patient safety.

Purpose of the Study:

• To identify patient, provider, and device characteristics associated with short-term PICC use (≤5 days).
• To assess clinical outcomes, including major and minor complications, related to short-term PICCs.

Main Methods:

• Data collected from 15,397 PICCs placed between January 2014 and June 2016 across 52 Michigan hospitals.
• Multivariable logistic regression analyzed factors associated with PICC dwell time of ≤5 days.
• Complications such as venous thromboembolism (VTE) and central line-associated bloodstream infection (CLABSI) were assessed.

Main Results:

• 25.3% of PICCs were used for ≤5 days, with most removed during hospitalization.
• Difficult venous access, multilumen devices, and teaching hospitals were associated with short-term PICC use.
• Complications occurred in 9.6% of short-term PICCs, including VTE (2.5%) and CLABSI (0.4%).
• Minor complications included catheter occlusion (4%) and tip migration (2.2%).

Conclusions:

• Short-term PICC use is common and influenced by patient, provider, and device factors.
• Even brief PICC placement is associated with significant complications.
• Interventions targeting the underlying reasons for short-term PICC use are necessary to mitigate risks.