External Validation of the Michigan Risk Score for Predicting Peripherally Inserted Central Catheter-Related Deep...

Area of Science:

• Vascular Access Devices
• Thrombosis Prediction
• Clinical Validation

Background:

• The Michigan Risk Score (MRS) was developed to predict peripherally inserted central catheter (PICC)-related thrombosis.
• External validation of the MRS in a Brazilian cohort was the primary objective.

Purpose of the Study:

• To validate the predictive performance of the Michigan Risk Score (MRS) for PICC-related thrombosis in a Brazilian population.
• To identify key clinical variables associated with PICC-related deep vein thrombosis (DVT).

Main Methods:

• A cohort of adult patients receiving PICCs across 16 Brazilian hospitals was prospectively followed.
• The MRS, based on five clinical variables, was assessed for its ability to predict DVT.
• Mixed-effects logistic regression was used to evaluate the MRS's calibration and discrimination.

Main Results:

• 12,725 PICCs in 11,135 patients were analyzed; 1.0% (129 cases) developed DVT.
• Only the number of PICC lumens and a history of venous thromboembolism (VTE) were significantly associated with DVT.
• The area under the curve for the MRS classification was 0.67, indicating moderate predictive ability.

Conclusions:

• PICC lumens and a history of VTE are independent predictors of DVT.
• Higher MRS risk classes (III and IV) were associated with increased DVT event rates compared to class I.
• The MRS demonstrated moderate performance in predicting PICC-related thrombosis in this Brazilian cohort.