title: The incidence of PICC line-associated thrombosis with and without the use of prophylactic anticoagulants.
abstract: BACKGROUND
  Indications for peripherally inserted central catheters (PICC) for long-term venous access have grown during the last several years. There are various complications associated with PICC lines, a common one being venous thrombosis. This study's purpose was to determine the incidence of venous thrombosis associated with PICCs with and without prophylactic anticoagulants.
  
  
  METHODS
  In this observational, prospective, cohort study, patients with PICC lines were evaluated using Doppler ultrasound for the presence of PICC-associated venous thrombosis at 5-7 days and again at 12-14 days after line placement. When present, clinical signs and symptoms of thrombosis were documented. Fifty-six patients were evaluated for the type of anticoagulation used, if any, and other clinical parameters such as smoking, ambulation, and previous surgery. The incidence of thrombus was then calculated for the entire population as well as for specific patient subgroups.
  
  
  RESULTS
  Patient age was 55.7 +/- 2.6 (mean +/- SEM) years, and BMI was 28.2 +/- 1.2 (n = 56). There were 38 (67.9%) nonambulatory subjects, 15 (26.8%) smokers, 4 (7.1%) coagulopathic subjects, 2 (3.6%) patients receiving estrogen-containing medications, 25 (44.6%) who had undergone surgery within the past 6 months, and 5 (8.9%) cancer patients. There were 21/56 patients (37.5%) with thrombus. Patients who received anticoagulation had a 22.9% (8/35) incidence of thrombosis, which was significantly less (P < .05) than for those who received no anticoagulant (13/21, 61.9%).
  
  
  CONCLUSIONS
  The use of anticoagulants for prophylaxis in patients with a PICC line was associated with a decreased rate of associated venous thrombosis.
authors.affiliation: Spectrum Health Metabolic Nutrition Support Service, Grand Rapids, MI 49503, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Paauw
authors.forename: Heather
authors.initials: H
authors.lastname: Borders
authors.forename: Nichole
authors.initials: N
authors.lastname: Ingalls
authors.forename: Sarah
authors.initials: S
authors.lastname: Boomstra
authors.forename: Susan
authors.initials: S
authors.lastname: Lambke
authors.forename: Brian
authors.initials: B
authors.lastname: Fedeson
authors.forename: Austin
authors.initials: A
authors.lastname: Goldsmith
authors.forename: Alan T
authors.initials: AT
authors.lastname: Davis
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants