Picc Line- Related Thrombosis; Does Pharmacological Deep Vein Thrombosis Help?

PICC LINE- RELATED THROMBOSIS; DOES PHARMACOLOGICAL DEEP VEIN THROMBOSIS HELP?

Yanal Alnimer, MD^*;Raad A Haddad, MD;Ahmad Abdalla, MD;Ghassan Bachuwa, MD and Carlos Rios-Bedoya, Hurley Medical Center/Michigan State University, Flint, MI

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract Number: 274

Category: Research

Sub-Category: Translating Research into Practice

Keywords: PICC LINE, PROPHYLAXIS and THROMBOSIS

Background: Peripherally inserted center catheter (PICC) use is associated with many complications including thromboembolism. The role of pharmacological prophylaxis in prevention of PICC line related thromboembolism is controversial. In our study,we assessed the role of pharmacological prophylaxis in the prevention of PICC line related thromboembolic complication.

Methods: We reviewed the electronic medical records in our center to collect data about Patients who had an ultrasound at the site of PICC line insertion and age ranges from 18-65 years old. The final population sample size consists of 227 patients who was included in the retrospective analysis. The sample population mean age was 57.3 ±18.5. Female constitutes 145 (64 %), and males were 82 (36%). 140 patients (62%) had ultrasound confirmed venous thrombosis at the site of PICC line insertion. About 50% of the patients had either deep venous thrombosis (DVT) or both DVT and superficial venous thrombosis, 28% had superficial thrombosis only, and 38% had no thrombosis. Pharmacological DVT prophylaxis in the form of either heparin or enoxaparin were given to 128 patients ( 56 %), and the rest had no pharmacological prophylaxis (44%). A multivariate logistic regression model was used to analyze the data.

Results: Using multivariate logistic regression model and after adjusting for other variables (Age, sex, BMI, ABO blood group and smoking history). Patients who had DVT prophylaxis had about 50% lower chance of developing PICC– related thrombosis compared to those without pharmacological DVT prophylaxis. Adjusted OR= 0.49, 95% CI (0.278-0.87 5) with a P value of 0.016.

Conclusions: Our study points out the importance of pharmacological DVT prophylaxis in preventing DVT in patients with PICC line insertion. Additional prospective study is needed to validate our conclusion.