title: Peripherally inserted central catheters (PICCs) in cancer patients under chemotherapy: A prospective study on the incidence of complications and overall failures.
abstract: OBJECTIVE
  The increasing use of peripherally inserted central venous catheters (PICCs) for chemotherapy has led to the observation of an elevated risk of complications and failures. This study investigates PICC failures in cancer patients.
  
  
  METHODS
  A prospective study was conducted at a single cancer institution on 291 PICC placement for chemotherapy. The primary study outcome was PICC failure.
  
  
  RESULTS
  Median follow-up was 119 days. PICC complications occurred in 72 patients (24.7%) and failures with removal in 44 (15.1%). Reasons for failures were upper extremity deep venous thrombosis (UEDVT) 12 (4.1%), central line associate bloodstream infection (CLABSI) 5 (1.7%) with an infection rate of 0.95 per 1,000 catheter days, exit site infection 9 (3.1%) with a rate of 1.46 per 1,000 catheter days, catheter dislodgment 11 (3.8%), and occlusion 7 (2.4%). Statistically significant risk factors were previous DVT (HR 2.95, 95%CI 1.33-6.53), reason for PICC implant (HR 3.65, 95%CI 1.12-10.34) and 5-fluorouracil, oxaliplatin and bevacizumab based chemotherapy (HR 3.11, 95%CI 1.17-8.26).
  
  
  CONCLUSIONS
  PICC is a safe venous device for chemotherapy delivery. Nevertheless, a 15% rate of failure has to be taken in account when planning PICC insertion for chemotherapy purposes. J. Surg. Oncol. 2016;113:708-714. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Surgical Sciences (DISC), University of Genova, Genova, Italy.|Genova-Italy Unit, Department of Surgery, IRRCS San Martino IST-National Institute for Cancer Research, Genova, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bertoglio
authors.affiliation: Health Nursing Office, IRRCS San Martino-IST National Institute for Cancer Research, Genova, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Faccini
authors.affiliation: Clinical Epidemiology Unit, IRRCS San Martino-IST National Institute for Cancer Research, Genova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Lalli
authors.affiliation: Genova-Italy Unit, Department of Surgery, IRRCS San Martino IST-National Institute for Cancer Research, Genova, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Cafiero
authors.affiliation: Clinical Epidemiology Unit, IRRCS San Martino-IST National Institute for Cancer Research, Genova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bruzzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D061807:Catheter Obstruction / Q000706:statistics & numerical data; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D020878:Device Removal / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies
chemical_list: D000970:Antineoplastic Agents
keywords: CLABSI; PICC; complications; deep vein thrombosis; venous access device