title: Retrospective cohort analysis comparing the incidence of deep vein thromboses between peripherally-inserted and long-term skin tunneled venous catheters in hemato-oncology patients.
abstract: BACKGROUND
  The introduction of central venous catheters has advanced medical care, particularly in hemato-oncology. However these can be associated with an increased thrombotic risk. Previous studies have compared the rate of thrombotic events between peripherally- inserted (PICCs) and long term skin tunneled catheters (LTSTCs) noting fewer complications associated with the latter, though this has rarely translated into clinical practice. The objectives of our study was to compare the cumulative incidence of thrombotic events between peripherally-inserted and long term skin tunneled venous catheters.
  
  
  METHODS
  We performed a retrospective, single center cohort analysis of patients with hematological malignancies who had either a PICC or LTSTC line inserted between January 2010 through January 2013. Cumulative incidences of thrombotic events were compared between the two groups, and post-thrombotic complications were also examined.
  
  
  RESULTS
  346 patients had a PICC inserted with cumulative incidence of symptomatic thrombosis of 5.8%, while 237 patients had a LTSTC inserted with a cumulative incidence of 1.7% (p = 0.003). Post-thrombotic complication rates, particularly infection, were higher in the PICC group compared to the LTSTC group (p = 0.597).
  
  
  CONCLUSIONS
  Our study showed that the incidence of thrombotic events in hemato-oncology patients was significantly lower in those who had a LTSTC compared to PICC line. As the use of central venous lines increases in hemato-oncology patient care, a randomized trial comparing PICCs and LTSTCs is necessary to address which venous access is most appropriate in this cohort of patients, with minimal risk of morbidity and mortality.
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Priya
authors.initials: P
authors.lastname: Sriskandarajah
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Katharine
authors.initials: K
authors.lastname: Webb
authors.affiliation: Department of Anesthetics, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: David
authors.initials: D
authors.lastname: Chisholm
authors.affiliation: Department of Anesthetics, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Ravi
authors.initials: R
authors.lastname: Raobaikady
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Kim
authors.initials: K
authors.lastname: Davis
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Pepper
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Ethell
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Mike N
authors.initials: MN
authors.lastname: Potter
authors.affiliation: Department of Haem-Oncology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK.
authors.forename: Bronwen E
authors.initials: BE
authors.lastname: Shaw
keywords: Catheter-related deep vein thrombosis; Cohort study; Doppler ultrasonography; Long term skin tunneled catheterisation; Venous thromboembolism