The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis

被引:12
作者
Puri, Anju [1 ]
Dai, Haiyun [2 ]
Giri, Mohan [2 ]
Wu, Chengfei [1 ]
Huang, Huanhuan [1 ]
Zhao, Qinghua [1 ]
机构
[1] Chongqing Med Univ, Affiliated Hosp 1, Dept Nursing, Chongqing, Peoples R China
[2] Chongqing Med Univ, Affiliated Hosp 1, Dept Resp & Crit Care Med, Chongqing, Peoples R China
来源
FRONTIERS IN CARDIOVASCULAR MEDICINE | 2022年 / 9卷
关键词
peripherally inserted central catheters; deep vein thrombosis; pulmonary embolism; meta-analysis; venous thromboembolism; central venous catheters; DEEP-VEIN THROMBOSIS; CANCER-PATIENTS; RETROSPECTIVE ANALYSIS; PICC; COMPLICATIONS; CARE; CHEMOTHERAPY; SAFETY; RATES; LINES;
D O I
10.3389/fcvm.2022.917572
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Venous thromboembolism ( VTE) can be fatal if not treated promptly, and individual studies have reported wide variability in rates of VTE associated with peripherally inserted central catheters (PICC). We thus conducted this meta-analysis to investigate the overall incidence and risk of developing PICC-related VTE in hospitalized patients. Methods: We searched PubMed, Embase, Scopus, and Web of Science databases from inception until January 26, 2022. In studies with a noncomparison arm, the pooled incidence of PICC-related VTE was calculated. The pooled odds ratio (OR) was calculated to assess the risk of VTE in the studies that compared PICC to the central venous catheter (CVC). The Newcastle-Ottawa Scale was used to assess methodological quality. Results: A total of 75 articles (58 without a comparison arm and 17 with), including 109292 patients, were included in the meta-analysis. The overall pooled incidence of symptomatic VTE was 3.7% (95% CI: 3.1-4.4) in noncomparative studies. In the subgroup meta-analysis, the incidence of VTE was highest in patients who were in a critical care setting (10.6%; 95% CI: 5.0-17.7). Meta-analysis of comparative studies revealed that PICC was associated with a statistically significant increase in the odds of VTE events compared with CVC (OR, 2.48; 95% CI, 1.83-3.37; P < 0.01). However, in subgroup analysis stratified by the study design, there was no significant difference in VTE events between the PICC and CVC in randomized controlled trials (OR, 2.28; 95% CI, 0.77-6.74; P = 0.13). Conclusion: Best practice standards such as PICC tip verification and VTE prophylaxis can help reduce the incidence and risk of PICC-related VTE. The risk-benefit of inserting PICC should be carefully weighed, especially in critically ill patients. Cautious interpretation of our results is important owing to substantial heterogeneity among the studies included in this study.
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页数:20
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共 99 条
[1]   Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC) [J].
Abdullah, JJ ;
Mohammad, N ;
Sangkar, JV ;
Aziz, YFA ;
Gan, GG ;
Goh, KY ;
Benedict, I .
BRITISH JOURNAL OF RADIOLOGY, 2005, 78 (931) :596-600
[2]   Utilization and Complications of Central Venous Access Devices in Oncology Patients [J].
Akhtar, Narmeen ;
Lee, Linda .
CURRENT ONCOLOGY, 2021, 28 (01) :367-377
[3]   Predictive risk factors of venous thromboembolism (VTE) associated with peripherally inserted central catheters (PICC) in ambulant solid cancer patients: retrospective single Centre cohort study [J].
Al-Asadi, Osamah ;
Almusarhed, Manar ;
Eldeeb, Hany .
THROMBOSIS JOURNAL, 2019, 17 (1)
[4]   Venous thrombosis associated with the placement of peripherally inserted central catheters [J].
Allen, AW ;
Megargell, JL ;
Lynch, FC ;
Singh, H ;
Singh, Y ;
Waybill, PN .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2000, 11 (10) :1309-1314
[5]   Incidence and predictive factors of symptomatic thrombosis related to peripherally inserted central catheters in chemotherapy patients [J].
Aw, Andrew ;
Carrier, Marc ;
Koczerginski, Joshua ;
McDiarmid, Sheryl ;
Tay, Jason .
THROMBOSIS RESEARCH, 2012, 130 (03) :323-326
[6]   Peripherally inserted central catheter-related thrombosis rate in modern vascular access era-when insertion technique matters: A systematic review and meta-analysis [J].
Balsorano, Paolo ;
Virgili, Gianni ;
Villa, Gianluca ;
Pittiruti, Mauro ;
Romagnoli, Stefano ;
De Gaudio, Angelo Raffaele ;
Pinelli, Fulvio .
JOURNAL OF VASCULAR ACCESS, 2020, 21 (01) :45-54
[7]   Peripherally inserted central catheters (PICCs) in the management of oncohematological patients submitted to autologous stem cell transplantation [J].
Bellesi, Silvia ;
Chiusolo, Patrizia ;
De Pascale, Gennaro ;
Pittiruti, Mauro ;
Scoppettuolo, Giancarlo ;
Metafuni, Elisabetta ;
Giammarco, Sabrina ;
Sora, Federica ;
Laurenti, Luca ;
Leone, Giuseppe ;
Sica, Simona .
SUPPORTIVE CARE IN CANCER, 2013, 21 (02) :531-535
[8]   Peripherally Inserted Central Catheters (PICCs) in Cancer Patients Under Chemotherapy: A Prospective Study on the Incidence of Complications and Overall Failures [J].
Bertoglio, Sergio ;
Faccini, Beatrice ;
Lalli, Luca ;
Cafiero, Ferdinando ;
Bruzzi, Paolo .
JOURNAL OF SURGICAL ONCOLOGY, 2016, 113 (06) :708-714
[9]   Peripherally inserted central venous catheters and central venous catheters related thrombosis in post-critical patients [J].
Bonizzoli, Manuela ;
Batacchi, Stefano ;
Cianchi, Giovanni ;
Zagli, Giovanni ;
Lapi, Francesco ;
Tucci, Valentina ;
Martini, Giacomo ;
Di Valvasone, Simona ;
Peris, Adriano .
INTENSIVE CARE MEDICINE, 2011, 37 (02) :284-289
[10]   A Randomized Trial of Complications of Peripherally and Centrally Inserted Central Lines in the Neuro-Intensive Care Unit: Results of the NSPVC Trial [J].
Brandmeir, Nicholas J. ;
Davanzo, Justin R. ;
Payne, Russell ;
Sieg, Emily P. ;
Hamirani, Ashiya ;
Tsay, Annie ;
Watkins, Jeffrey ;
Hazard, Sprague W. ;
Zacko, J. Christopher .
NEUROCRITICAL CARE, 2020, 32 (02) :400-406