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Patient-reported complications regarding PICC lines after inpatient discharge


 

Background: Despite the rise in utilization of PICC lines, few studies have addressed complications experienced by patients following PICC placement, especially subsequent to discharge from the inpatient setting.

Dr. Amanda Cooke, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston

Dr. Amanda Cooke


Study design: Prospective longitudinal study.

Setting: Medical inpatient wards at four U.S. hospitals in Michigan and Texas.

Synopsis: Standardized questionnaires were completed by 438 patients who underwent PICC line placement during inpatient hospitalization within 3 days of placement and at 14, 30, and 70 days. The authors found that 61.4% of patients reported at least one possible PICC-related complication or complaint. A total of 17.6% reported signs and symptoms associated with a possible bloodstream infection; however, a central line–associated bloodstream infection was documented in only 1.6% of patients in the medical record. Furthermore, 30.6% of patients reported possible symptoms associated with deep venous thrombosis (DVT), which was documented in the medical record in 7.1% of patients. These data highlight that the frequency of PICC-related complications may be underestimated when relying solely on the medical record, especially when patients receive follow-up care at different facilities. Functionally, 26% of patients reported restrictions in activities of daily living and 19.2% reported difficulty with flushing and operating the PICC.

Bottom line: More than 60% of patients with PICC lines report signs or symptoms of a PICC-related complication or an adverse impact on physical or social function.

Citation: Krein SL et al. Patient-­reported complications related to peripherally inserted central catheters: A multicenter prospective cohort study. BMJ Qual Saf. 2019 Jan 25. doi: 10.1136/bmjqs-2018-008726.

Dr. Cooke is a hospitalist at Beth Israel Deaconess Medical Center.

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