Thrombosis Rate and Risk Factors in Pediatric Patients with Peripherally Inserted Central Catheters

To determine symptomatic thrombosis incidence in pediatric patients with peripherally inserted central catheters (PICCs) and identify associated patient and procedure-related risk factors in a tertiary pediatric center in Saudi Arabia.

We conducted a retrospective cohort study at King Abdullah Specialized Children's Hospital, Riyadh, Kingdom of Saudi Arabia, including patients aged 0-14 years who underwent PICC insertion in the Interventional Radiology department between January 2019 and June 2023. Data on demographics, comorbidities, procedural details, and outcomes were extracted from the electronic medical record system (BestCare). Symptomatic thrombosis was defined as Doppler-confirmed thrombosis with clinical signs. Associations were tested using chi-square or Fisher's exact tests (p <0.05).

Among 168 patients, the incidence of symptomatic thrombosis was 16.7% (n = 28). In univariate analyses, female sex (p = 0.019), left-sided insertion (36.4% versus 13.7%, p = 0.014), nonbasilic vein access (53.8%, p = 0.001), and previous PICC exposure (p = 0.014) were associated with symptomatic thrombosis. A nonsignificant U-shaped trend was observed for indwelling time (<7 days, 35.7%; >180 days, 40.9%).

The PICC-related thrombosis is a clinically important complication in pediatric patients. Several patient and procedure-related factors were associated with symptomatic thrombosis in univariate analyses. These findings may help inform future prospective studies and strategies aimed at optimizing vascular access practices in children.