Analysis of related factors of deep venous thrombosis in upper extremity after PICC catheterization

Abstract

Objective To investigate the related risk factors of upper extremity deep venous thrombosis associated with peripherally inserted central catheter(PICC). Methods From January 2014 to February 2018, 300 patients with PICC in the No.117 Hospital of the Chinese People's Liberation Army were selected in the study, of whom 30 patients developed deep venous thrombosis(thrombosis group), the other 270 patients had no deep venous thrombosis(non-thrombotic group). General data of the patients (gender, age, body mass index), catheter technical parameters(number of punctures, length of catheter, position of catheter tip), retention vessel index(inner side of catheter, indwelling vein, internal diameter of catheter), past history(history of hypertension, history of diabetes, history of oncology, history of cancer chemotherapy, history of smoking, history of blood clots, history of PICC, or CVP insertion), and laboratory tests(platelet count, plasma D-dimer, plasma fibrin original, prothrombin time) were collected.Univariate analysis was used to find out the differences between the thrombosis group and the non-thrombosis group.Logistic regression analysis was used to identify the risk factors for deep vein thrombosis of the upper extremities after PICC catheterization. Results Univariate analysis showed that variables that differed between the thrombus group and the non-thrombosis group included catheter tip location, diameter of the cannulated vein, history of cancer, history of chemotherapy, plasma D-dimer (χ2=4.556, 10.973, 11.940, 5.357, 11.623, P=0.033, 0.001, 0.001, 0.021, 0.001). Multivariate Logistic regression analysis showed that the risk factors of upper extremity deep venous thrombosis after PICC catheterization were catheter tip placement on the upper vena cava 2/3, catheter vein diameter<4mm, tumor history and chemotherapy history(P=0.014, 0.023, 0.017, 0.028). Conclusion The risk factors of upper extremity deep venous thrombosis after PICC catheterization are catheter tip placed on the upper 2/3 of the superior vena cava, diameter of the catheter vein<4 mm, tumor history and chemotherapy history. Key words: Catheterization, central venous; Catheterization, peripheral; Vena cava, superior; Thrombosis; Risk factors