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Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study
BACKGROUND: Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients and among outpatients. Despite many advantages, PICC-related complications can occur such as infection, thrombosis or mechanical complications. We aimed to evaluate rates and nature of PICC-related...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5273851/ https://www.ncbi.nlm.nih.gov/pubmed/28149507 http://dx.doi.org/10.1186/s13756-016-0161-0 |
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author | Grau, Delphine Clarivet, Béatrice Lotthé, Anne Bommart, Sébastien Parer, Sylvie |
author_facet | Grau, Delphine Clarivet, Béatrice Lotthé, Anne Bommart, Sébastien Parer, Sylvie |
author_sort | Grau, Delphine |
collection | PubMed |
description | BACKGROUND: Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients and among outpatients. Despite many advantages, PICC-related complications can occur such as infection, thrombosis or mechanical complications. We aimed to evaluate rates and nature of PICC-related complications from insertion to removal and analyze risk factors of complications at baseline and during healthcare. METHODS: We performed a prospective cohort study looking at PICC-related complication rates in the inpatient and outpatient settings of 163 patients over a 7-month period. Pertinent patient demographics as well as catheter-related factors were collected. The data were analyzed to identify catheter-related complications using univariate and multivariate analysis. RESULTS: One hundred ninety-two PICCs were monitored for a total of 5218 PICC-days (3337 PICC-days for inpatients, 1881 PICC-days for outpatients). The overall complication rate was 30.2% (11.1 per 1000 PICC-days) with a mean time to onset of 16.1 days. Complications included occlusion (8.9%), accidental withdrawal (8.9%), infections (6.3%) including 9 local infections (4.7%) and 3 bloodstream infections (1.6%), venous thrombosis (1.6%) and hematoma (1%). Complication rate was higher in the hospitalization setting (36.1%; 14.38 per 1000 PICC-days) than in the outpatient setting (19.4%; 3.19 per 1000 PICC-days). Multivariate logistic regression analysis showed that the occurrence of occlusion was significantly associated with an age > 65 years (OR = 4.19; 95% CI [1.1–15.81]) and the presence of a pre-occlusive event the week before PICC removal (OR = 76.35; 95% CI [9.36–622.97]). CONCLUSIONS: PICCs appear safe in the inpatient and outpatient settings with low rates of infectious or thrombotic complications. Occlusion and accidental withdrawal were the most common complications, with age > 65 and catheter pre-occlusive event associated with an increased likelihood of catheter occlusion. |
format | Online Article Text |
id | pubmed-5273851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-52738512017-02-01 Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study Grau, Delphine Clarivet, Béatrice Lotthé, Anne Bommart, Sébastien Parer, Sylvie Antimicrob Resist Infect Control Research BACKGROUND: Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients and among outpatients. Despite many advantages, PICC-related complications can occur such as infection, thrombosis or mechanical complications. We aimed to evaluate rates and nature of PICC-related complications from insertion to removal and analyze risk factors of complications at baseline and during healthcare. METHODS: We performed a prospective cohort study looking at PICC-related complication rates in the inpatient and outpatient settings of 163 patients over a 7-month period. Pertinent patient demographics as well as catheter-related factors were collected. The data were analyzed to identify catheter-related complications using univariate and multivariate analysis. RESULTS: One hundred ninety-two PICCs were monitored for a total of 5218 PICC-days (3337 PICC-days for inpatients, 1881 PICC-days for outpatients). The overall complication rate was 30.2% (11.1 per 1000 PICC-days) with a mean time to onset of 16.1 days. Complications included occlusion (8.9%), accidental withdrawal (8.9%), infections (6.3%) including 9 local infections (4.7%) and 3 bloodstream infections (1.6%), venous thrombosis (1.6%) and hematoma (1%). Complication rate was higher in the hospitalization setting (36.1%; 14.38 per 1000 PICC-days) than in the outpatient setting (19.4%; 3.19 per 1000 PICC-days). Multivariate logistic regression analysis showed that the occurrence of occlusion was significantly associated with an age > 65 years (OR = 4.19; 95% CI [1.1–15.81]) and the presence of a pre-occlusive event the week before PICC removal (OR = 76.35; 95% CI [9.36–622.97]). CONCLUSIONS: PICCs appear safe in the inpatient and outpatient settings with low rates of infectious or thrombotic complications. Occlusion and accidental withdrawal were the most common complications, with age > 65 and catheter pre-occlusive event associated with an increased likelihood of catheter occlusion. BioMed Central 2017-01-28 /pmc/articles/PMC5273851/ /pubmed/28149507 http://dx.doi.org/10.1186/s13756-016-0161-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Grau, Delphine Clarivet, Béatrice Lotthé, Anne Bommart, Sébastien Parer, Sylvie Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study |
title | Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study |
title_full | Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study |
title_fullStr | Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study |
title_full_unstemmed | Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study |
title_short | Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study |
title_sort | complications with peripherally inserted central catheters (piccs) used in hospitalized patients and outpatients: a prospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5273851/ https://www.ncbi.nlm.nih.gov/pubmed/28149507 http://dx.doi.org/10.1186/s13756-016-0161-0 |
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