Infection Rate of Hickman Catheters Versus Peripherally Inserted Central Venous Catheters in Oncology Patients

Objective: To compare the incidence of catheter-related infection in the bloodstream and non-infectious complication rate of Hickman catheter and peripherally inserted central venous catheter (PICC) in oncology patients. Methods: A retrospective study was performed of oncology patients who underwent Hickman catheter or PICC placement at the radiology department of a regional hospital in Hong Kong from January 2008 to December 2013. The catheter-related bloodstream infection rate, time to infection onset, and non-infectious complication rate of the Hickman group and PICC group were evaluated and compared. Results: During the study period, 161 Hickman catheters and 29 PICCs were inserted in oncology patients (n = 190). There were 38 cases of catheter-related bloodstream infection in the Hickman group and four cases in the PICC group. The catheter-related bloodstream infection rate for all catheters, Hickman group, and PICC group was 1.364, 1.340 and 1.654 per 1000-catheter-days, respectively. For non-infectious complications, 15 of 161 Hickman cases had complications (6 catheter blockage, 5 leakage, 4 migration and dislodgement). In the PICC group, 6 of 29 had complications (3 blockage, and 3 migration and dislodgement). There was, however, no statistically significant difference between the Hickman and PICC groups in terms of number of infections (p = 0.241), time to infection onset (p = 0.187), non-infectious complication rate (p = 0.101), and overall complication rate (p = 0.766). Conclusion: With the less invasive nature of PICC insertion, it provides a viable means of vascular access for oncology patients.