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Updated: Jun 27, 2025
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Published on: March 31, 2023
Risk of deep venous thrombosis associated with peripherally inserted central catheter: A retrospective cohort study
Telma Christina do Campo Silva1, Luciene Muniz Braga2, Jose Mauro Vieira Junior3
1Department Nursing Specialized in Vascular Access, RN, MD. Hospital Sírio Libanês, São Paulo, São Paulo, Brazil.
Insights
Peripherally Inserted Central Catheter (PICC) use is associated with a low rate of Deep Venous Thrombosis (DVT), especially in cancer and critically ill patients. Advanced age, prior DVT, and device obstruction increase risk, while anticoagulation offers protection.
Area of Science:
- Vascular Medicine
- Critical Care Medicine
- Oncology
Background:
- Deep Venous Thrombosis (DVT) is a significant complication following Peripherally Inserted Central Catheter (PICC) insertion.
- Assessing DVT rates and associated risk factors in vulnerable patient populations is crucial.
Purpose of the Study:
- To determine the incidence of PICC-associated DVT.
- To identify independent risk factors for DVT in cancer and critically ill patients receiving PICCs.
Main Methods:
- A retrospective cohort study analyzed 11,588 PICC insertions from 2014 to 2019.
- Logistic regression identified factors associated with DVT risk.
- Data included pre- and post-puncture variables.
Main Results:
- The DVT prevalence was 1.8% (213/11,588 PICCs).
- Independent risk factors for DVT included older age, history of DVT, and device obstruction.
- Anticoagulant therapy was found to be a protective factor against DVT.
Conclusions:
- Peripherally Inserted Central Catheter (PICC) placement is a safe and effective method for medium to long-term intravenous therapy.
- Low DVT rates were observed even in high-risk groups like critically ill and cancer patients.
- Risk factor identification aids in optimizing patient safety during PICC use.
Introduction:
Deep Venous Thrombosis (DVT) due to Peripherally Inserted Central Catheter (PICC) is one of the most threatening complications after device insertion.
Objective:
To assess the rate of PICC-associated DVT and analyze the risk factors associated with this event in cancer and critically ill patients.
Methods:
We conducted a descriptive, retrospective cohort study with 11,588 PICCs from December 2014 to December 2019. Patients ≥ 18 years receiving a PICC were included. Pre-and post-puncture variables were collected and a logistic regression was used to identify the independent factors associated with the risk of DVT.
Results:
The DVT prevalence was 1.8% (n = 213). The median length of PICC use was 15.3 days. The median age was 75 years (18; 107) and 52% were men, 53.5% were critically ill and 29.1% oncological patients. The most common indications for PICC's were intravenous antibiotics (79.1%). Notably, 91.5% of PICC showed a catheter-to-vein ratio of no more than 33%. The tip location method with intracavitary electrocardiogram was used in 43%. Most catheters (67.9%) were electively removed at the end of intravenous therapy. After adjusting for cancer profile ou chemotherapy, regression anaysis revealed that age (OR 1.011; 95% CI 1.002-1.020), previous DVT (OR 1.96; 95% CI 1.12-3.44) and obstruction of the device (OR 1.60; 95% CI 1.05-2.42) were independent factors associated with PICC-associated DVT, whereas the use of an anticoagulant regimen was a protective variable (OR 0.73; 95% CI 0.54-0.99).
Conclusion:
PICC is a safe and suitable intravenous device for medium and long-term therapy, with low rates of DVT even in a cohort of critically ill and cancer patients.
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