Abstract No. 118 A multicenter observational study to determine the incidence of catheter-related venous thrombosis using a novel antimicrobial and anti-thrombogenic peripherally inserted central catheter

Abstract

This study evaluated the impact of a novel antimicrobial and antithrombogenic peripherally inserted central catheter (PICC) and its impact on associated complications within inpatient and outpatient populations. Various strategies are used in an attempt to decrease the incidence of catheter-related complications. This IRB-approved, multicenter, prospective observational study was performed at 3 large US academic hospitals. Adults who required PICC ≥14 days were considered. Patients were monitored throughout entire catheter dwell, to a maximum of 90 days. Data was collected from hospital, outpatient and patient PICC records. Duplex venous ultrasounds were performed for thrombosis before insertion, dwell day 10-14 and upon removal. 103 patients were enrolled through interventional radiology teams; 56% were male, mean BMI was 29 ± 8.8. Majority (79%) were high-risk groups—cancer, infectious diseases, transplant, and trauma. Primary indications were antibiotics (66.99%) and chemotherapy (25.24%). Double lumen PICCs (59%) and basilic vein (71.84%) were highest selected. Fourteen (13.5%) remained inpatients, (46.6%) were discharged to home health, (20.38%) to outpatient therapy, and (19.4%) into family care. Seven (6.8%) were lost to follow-up. Mean catheter dwell was 38.74 ± 25.81 days (n = 96); Eight (7.7%) PICCs remained indwelling and functional at day 90. Three (2.9%) CRBSIs were reported at days 14, 27, and 60 and were all dual-lumen catheters (59.2%). Seven (6.8%) reported symptomatic catheter-related thromboses (CRT) and 2 (28.5%) used a standardized catheter-vessel ratio vein measurement. Several patients with asymptomatic CRT at the initial screening had complete thrombosis resolution on follow-up scanning at removal. The incidence of CRBSI was 0.81/1000 days, compared to currently reported rates of 1.8–7.7/1000 days . The overall symptomatic CRT rate was 1.87/1000 days. Evans et al (2013) reported symptomatic CRT rates of 2.7–4.3/1000 days. The focus on patient harm and safety have contributed to the implementation of infection prevention and thrombosis-reduction strategies. Antimicrobial PICCs should be considered for use in high-risk populations.