title: Incidence and predictive factors of symptomatic thrombosis related to peripherally inserted central catheters in chemotherapy patients.
abstract: BACKGROUND
  The incidence of symptomatic catheter-related deep vein thrombosis (DVT) in cancer patients remains unclear and there is a lack of reliable data on the risk factors of PICC-related DVT.
  
  
  METHODS
  We performed a retrospective cohort study of consecutive cancer patients who received an ultrasound guided PICC line for the administration of chemotherapy. Univariable and multivariable logistic regression analyses were performed to identify risk factors for symptomatic PICC-related DVT.
  
  
  RESULTS
  In total, 340 cancer patients obtained PICC lines for the administration of chemotherapy. Of these patients, 19 (5.6%; 95% CI: 3.6-8.6) developed symptomatic PICC-related DVT. Factors previously associated with catheter-related DVT, including side of catheter placement, lumen size, tip location, need for repositioning, and number of insertion attempts, were not significant determinants in our analysis. Patients with diabetes were three times more likely to develop PICC-related DVT (OR 3.0, p=0.039), while the presence of COPD and metastatic cancer also increased the odds (OR 3.3, p=0.078 and OR 2.3, p=0.083 respectively). Diabetes remained a significant risk factor after adjustment for effect of metastases and COPD (OR 3.175, p=0.039). Further, the presence of metastases was a significant predictor (OR 3.34, p=0.024) in our multivariable model.
  
  
  CONCLUSIONS
  Symptomatic PICC-related DVT are frequent in cancer patients receiving chemotherapy. Previously described factors associated with catheter-related thrombosis were not predictive of PICC-related DVT in our study. Diabetes, advanced disease and COPD appear to increase the risk of developing PICC-related DVT in chemotherapy patients.
authors.affiliation: Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Aw
authors.forename: Marc
authors.initials: M
authors.lastname: Carrier
authors.forename: Joshua
authors.initials: J
authors.lastname: Koczerginski
authors.forename: Sheryl
authors.initials: S
authors.lastname: McDiarmid
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D012307:Risk Factors; D056824:Upper Extremity Deep Vein Thrombosis / Q000453:epidemiology*
chemical_list: D000970:Antineoplastic Agents