Ingram et al reported risk factors for catheter-related thrombosis during outpatient parenteral antibiotic therapy (OPAT). The authors are from University of Western Australia, Royal Perth Hospital, Fiona Stanley Hospital, National University of Ireland and Griffith University.
Patient selection: outpatient parenteral antibiotic therapy (OPAT) using a peripherally inserted central catheter (PICC line)
Prevalence of thrombosis: 1.1%
Risk factors for catheter-related thrombosis:
(1) malposition of the catheter (location proximal or distal to the cavoatrial junction)
(2) complicated catheter insertion (multiple insertion attempts, coiling, difficult passage due to stenosis)
Active malignancy had a p-value of 0.077 and could contribute to risk.
Previous venous thrombosis was not a significant risk factor. The status of overall thrombotic risk was not well investigated.
Vascular access care was provided by trained registered nurses. It is not clear how many patients received therapy in outpatient clinics or at home.
A patient at higher risk of thrombosis may benefit from anticoagulation, but this should not be given routinely.
Complications:
(1) unplanned readmission
(2) pulmonary emboli
