title: Peripherally inserted central venous catheter-associated thrombosis: retrospective analysis of clinical risk factors in adult patients.
abstract: BACKGROUND
  Peripherally inserted central catheters (PICC) are common venous access devices. Clinical conditions and therapies that increase the risk of PICC-associated thrombosis have not been studied.
  
  
  METHODS
  We performed a retrospective case-control analysis of all adult patients who underwent placement of a PICC at our hospital over a three-year period (n = 1296). Clinical variables examined were indication for PICC placement, active cancer treatment, history of DVT, diabetes mellitus, and use of prophylactic anticoagulation.
  
  
  RESULTS
  The overall incidence of PICC-associated DVT was 2% (n = 27). Active cancer therapy was significantly associated with PICC-associated DVT (OR 3.5, 95% CI 1.3-9.8). The use of prophylactic anticoagulation did not reduce this risk.
  
  
  CONCLUSIONS
  Patients who suffered a PICC-associated DVT were more likely to be undergoing treatment for cancer. This risk was not lowered by the use of prophylactic anticoagulation. These results suggest a need for prospective studies on effective anticoagulation for patients at high risk for PICC-associated DVT.
authors.affiliation: Department of Internal Medicine, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX 78236, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: King
authors.forename: Mark S
authors.initials: MS
authors.lastname: Rasnake
authors.forename: Rechell G
authors.initials: RG
authors.lastname: Rodriguez
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Riley
authors.forename: Jason A
authors.initials: JA
authors.lastname: Stamm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*