Chopra et al identified risk factors for thrombosis involving a peripherally-inserted central catheter (PICC). These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Michigan Health System, The Patient Safety Enhancement Program and the VA Ann Arbor Healthcare System.
Patient selection: PICC line
Outcome: upper extremity deep vein thrombosis, ultrasound confirmed
Risk factors for thrombosis related to the patient:
(1) previous history of thromboembolism
(2) surgery while PICC line was in situ
(3) failure to receive aspirin and/or statin (risk lowest if both given)
(4) failure to receive pharmacological DVT prophylaxis
Risk factors related to the PICC line:
(1) insertion by other than vascular access nurse
(2) 5 or 6 French catheter (vs 4 French)
(3) insertion into brachial or cephalic vein (vs basilic vein)
The risk for thrombosis increases with the number of risk factors.
