The Risk of Deep Venous Thrombosis and Sepsis in Cancer Patients Due to PICC Lines.

Context

Upper extremity deep venous thrombosis (DVT) represents 8–10% of total DVT of the limb. Long term central venous catheters represent a major cause of upper extremity DVT, especially in cancer patients. This study looks specifically at the risk posed by peripherally inserted central catheters (PICC).

Purpose of the Study:

To assess the risk of DVT and sepsis due to PICC lines in cancer patients as compared to non-cancer patients. Furthermore, to assess the risk of PICC line related DVT and sepsis among different cancer types.

Design, Setting, and Patients:

Retrospective chart review of all 190 patients (representing n=244 procedures) who had undergone a PICC line procedure in Union Memorial Hospital (Baltimore, MD) from August 2003 to December 2003. Based on their medical records, it was determined whether or not the patient had experienced PICC line related sepsis or thrombosis. Cancer as a potential risk factor was included in the information collected. 33 of 190 patients were cancer patients. Average patient age 56.7 years.

Results:

Preliminary results show that from August 1, 2003 to December 5, 2003, among the non-cancer patients 6 (3.8%) patients with DVT and 6 (3.8%) patients with sepsis were identified. Among the cancer patients, 3 (9.1%) patients with DVT and 3 (9.1%) patients with sepsis were identified. Though cancer patients made up only 17.4% of the patient population, they represented 33.3% of the cases of DVT and sepsis.

Conclusion:

Cancer patients are at a greater risk of thromboses and sepsis due to PICC lines as compared to non-cancer patients. Cancer patients, therefore, represent a unique population of PICC line patients who may require a different protocol of prophylaxis and complication prevention. While different types of cancers may pose different levels of risk (Sorensen et al), this could not be determined with confidence with the preliminary findings due to the small population evaluated so far.

Non-cancer patients

Cancer patients