Amanda Cooke, MD

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.

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.

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.

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.

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.

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.