D‐dimer level for ruling out peripherally inserted central catheter‐associated upper extremity deep vein thrombosis and superficial vein thrombosis

AIMS: To examine the effectiveness of D‐dimer values to be used as an independent diagnostic marker for excluding peripherally inserted central catheter‐associated upper extremity deep vein thrombosis and superficial vein thrombosis. DESIGN: This was a retrospective case–cohort study. METHODS: Records were reviewed for 281 patients who underwent peripherally inserted central catheter insertion between 1 October 2017 and 1 October 2019. According to the modified Wells score after peripherally inserted central catheter insertion, the patients who had low vein thrombosis risk underwent a D‐dimer test and colour Doppler ultrasound. RESULTS: Among 281 patients, 180 patients (64%, 95% CI: 58.2%–69.4%) had negative D‐dimer results and 39 of 180 patients had vein thrombosis despite having a negative D‐dimer result, resulting in a failure rate of 21.7% (95% CI: 16.3%–28.3%). The negative predictive value of peripherally inserted central catheter‐associated vein thrombosis in the cancer group (80.0%, 95% CI: 73.2%–85.4%) was higher than that of the non‐cancer group (60.0%, 95% CI: 35.7%–80.2%). The negative predictive value of peripherally inserted central catheter‐associated deep venous thrombosis (84.9%, 95% CI: 78.7%–89.6%) was lower than that of the PICC‐associated superficial venous thrombosis (91.0%, 95% CI: 85.4%–94.6%). CONCLUSION: The D‐dimer levels maybe should not be used as a diagnostic index to rule out peripherally inserted central catheter‐associated upper extremity vein thrombosis.