The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis

作者全名："Puri, Anju; Dai, Haiyun; Giri, Mohan; Wu, Chengfei; Huang, Huanhuan; Zhao, Qinghua"

作者地址："[Puri, Anju; Wu, Chengfei; Huang, Huanhuan; Zhao, Qinghua] Chongqing Med Univ, Affiliated Hosp 1, Dept Nursing, Chongqing, Peoples R China; [Dai, Haiyun; Giri, Mohan] Chongqing Med Univ, Affiliated Hosp 1, Dept Resp & Crit Care Med, Chongqing, Peoples R China"

通信作者："Zhao, QH (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Nursing, Chongqing, Peoples R China."

来源：FRONTIERS IN CARDIOVASCULAR MEDICINE

ESI学科分类：　

WOS号：WOS:000877062500001

JCR分区：Q2

影响因子：3.6

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：peripherally inserted central catheters; deep vein thrombosis; pulmonary embolism; meta-analysis; venous thromboembolism; central venous catheters

摘要："Background: Venous thromboembolism ( VTE) can be fatal if not treated promptly, and individual studies have reported wide variability in rates of VTE associated with peripherally inserted central catheters (PICC). We thus conducted this meta-analysis to investigate the overall incidence and risk of developing PICC-related VTE in hospitalized patients. Methods: We searched PubMed, Embase, Scopus, and Web of Science databases from inception until January 26, 2022. In studies with a noncomparison arm, the pooled incidence of PICC-related VTE was calculated. The pooled odds ratio (OR) was calculated to assess the risk of VTE in the studies that compared PICC to the central venous catheter (CVC). The Newcastle-Ottawa Scale was used to assess methodological quality. Results: A total of 75 articles (58 without a comparison arm and 17 with), including 109292 patients, were included in the meta-analysis. The overall pooled incidence of symptomatic VTE was 3.7% (95% CI: 3.1-4.4) in noncomparative studies. In the subgroup meta-analysis, the incidence of VTE was highest in patients who were in a critical care setting (10.6%; 95% CI: 5.0-17.7). Meta-analysis of comparative studies revealed that PICC was associated with a statistically significant increase in the odds of VTE events compared with CVC (OR, 2.48; 95% CI, 1.83-3.37; P < 0.01). However, in subgroup analysis stratified by the study design, there was no significant difference in VTE events between the PICC and CVC in randomized controlled trials (OR, 2.28; 95% CI, 0.77-6.74; P = 0.13). Conclusion: Best practice standards such as PICC tip verification and VTE prophylaxis can help reduce the incidence and risk of PICC-related VTE. The risk-benefit of inserting PICC should be carefully weighed, especially in critically ill patients. Cautious interpretation of our results is important owing to substantial heterogeneity among the studies included in this study."

基金机构：Chongqing Municipal Education Commission [yjg211006]

基金资助正文：This study was supported by Chongqing Municipal Education Commission (Grant/Award Number: yjg211006).