Risk factors for upper limb deep venous thrombosis (DVT) associated with peripherally inserted central catheters (PICCs) in cancer patients

Background

Peripherally inserted central catheters (PICCs) are associated with an increased risk of upper limb deep vein thrombosis (DVT). In Oxford University Hospitals, PICCs are widely used for the delivery of chemotherapy in cancer patients. We aimed to investigate the incidence and risk factors for PICC-associated DVT in cancer patients.

Methods

This was a single centre study at a tertiary centre in Oxford. We obtained details of all patients who had PICCs inserted in 2015 under the vascular access department in the hospital. Gender, Body Mass Index (BMI), cancer type and chemotherapy regime were matched to these patients. A diagnosis of upper limb DVT was confirmed from diagnostic imaging. Retrospective analysis on the data was performed.

Results

454 oncology patients had PICCs inserted in 2015. 18 patients (4%) developed a DVT. Gender proportions were similar between the DVT and non-DVT cohorts (72% female vs 73% female, p = 0.95). Median BMI was 27.43kg in those with DVTs and 26.84 in those without DVTs (p = 0.65). Breast cancer and colorectal cancer were the most common cancer types in the DVT cohort and breast cancer was over-represented whilst colorectal cancer under-represented compared to the non- DVT cohort (Table 1) (p = 0.59). A higher proportion of patients with DVTs received FEC-T chemotherapy compared to patients without DVTs (39% vs 25%, p = 0.20).

Cancer types in patients with DVTs and without DVTs

Conclusions

Other studies have extensively analysed risk factors for PICC thrombosis but have not focused on types of cancer or chemotherapy. In our study, breast cancer and FEC-T chemotherapy appeared to be over-represented in the DVT cohort, however this did not reach statistical significance. We are currently performing further work using data from previous years to see if this trend continues.

Clinical trial identification

Legal entity responsible for the study

Oxford University Hospitals

Funding

Oxford University Hospitals

Disclosure

All authors have declared no conflicts of interest.