Risk Factors associated with upper extremity deep vein thrombosis following PICC insertion

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PICC-related UEDVT is a common complication. Active cancer and higher baseline C-reactive protein level were associated with the occurrence of this condition” Levy et al (2019).

Abstract:

BACKGROUND: The occurrence of upper extremity deep vein thrombosis (UEDVT) is not uncommon following peripherally inserted central catheter (PICC) insertion. However, the risk factors associated with this condition are unknown. Moreover, the role of prophylactic anticoagulation in the prevention of PICC-related UEDVT is not well established.

METHODS: A review of the medical records of all patients who underwent PICC insertion during 2016 at the Hadassah Medical Center.

RESULTS: Overall, 500 patients underwent PICC insertion during the study period. Of them, 199 (39.8%) received prophylactic anticoagulation following insertion. Patients with active cancer were less likely to receive prophylactic anticoagulation. Twenty-five (5.0%) patients experienced PICC-related UEDVT, which occurred after a median of 8 days following PICC placement. The only factors associated with the development of UEDVT were the presence of active cancer (P=0.04) and higher C-reactive protein level (P=0.02). The rate of UEDVT was comparable between those who received prophylactic anticoagulation and those who did not (P=0.98).

CONCLUSIONS: PICC-related UEDVT is a common complication. Active cancer and higher baseline C-reactive protein level were associated with the occurrence of this condition. Future studies are warranted to confirm our findings and further assess the role of prophylactic anticoagulation in this setting.

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Reference:

Levy, S., Rottenstreich, A. and Kalish, Y. (2019) Risk Factors Associated with the Development of Upper Extremity Deep Vein Thrombosis Following Peripherally Inserted Central Catheter Insertion. Harefuah. 158(3), p.150-154. .

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