title: Evaluation of PICC complications in orthopedic inpatients with bone infection for long-term intravenous antibiotics therapy.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the complications of peripherally inserted central catheters (PICCs) in orthopedic patients with chronic bone orthopedic infection.
  
  
  METHODS
  The institutional review board approved this retrospective study and informed consent was waived. Records of 180 consecutives PICCs placed in patients hospitalized in the orthopedic surgery department were reviewed. All patients had bones infections necessitating a long-term intravenous antibiotics therapy. All PICC complications were recorded during the patient hospitalization: infection [catheter-related bloodstream infection (CRBSI), central line associated bloodstream infection (CLABSI), exit-site infection, septic phlebitis], thrombosis, occlusion, mechanical complication (accidental withdrawal, malposition, median nerve irritation).
  
  
  RESULTS
  One hundred and eighty PICCs were placed in 136 patients. Mean duration of catheterization was 21 days (total 3911 PICC-days). Thirty-six PICCs (20%) were removed due to complications (9.2 complications per 1000 PICC-days): 14 (8%) infections (one CRBSI (Pseudomonas aeruginosa), one septic phlebitis (P. aeruginosa), two exit-site infections and 10 CLABSIs), 11 (6%) occlusions, and 12 (7%) mechanical complications (10 accidental withdrawals, one malposition, one median nerve irritation). One patient had two complications simultaneously. After multivariate analysis, two risk factors were significantly associated with the overall occurrence of complications: age more than 70 years [OR = 2.89 (1.06-7.89], p = 0.04] and number of lumen at least two [OR = 2.64 (1.03-6.75), p = 0.04].
  
  
  CONCLUSIONS
  Even in orthopedic patients with chronic orthopedic bone infection, PICCs have a low rate of complication. The increasing lumen number of the PICC is a potential risk factor in our series.
authors.affiliation: Radiology Department, Begin Military Hospital, Saint Mandé - France.
authors.forename: Laura
authors.initials: L
authors.lastname: Valbousquet Schneider
authors.forename: Sandrine
authors.initials: S
authors.lastname: Duron
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Arnaud
authors.forename: Aurore
authors.initials: A
authors.lastname: Bousquet
authors.forename: Yann
authors.initials: Y
authors.lastname: Kervella
authors.forename: Caroline
authors.initials: C
authors.lastname: Bouzad
authors.forename: Jacques
authors.initials: J
authors.lastname: Baccialone
authors.forename: Christophe
authors.initials: C
authors.lastname: A'Teriitehau
authors.forename: Julien
authors.initials: J
authors.lastname: Potet
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001850:Bone Diseases, Infectious / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D061807:Catheter Obstruction / Q000209:etiology*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D004867:Equipment Design; D005260:Female; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents